This story reports on the blood pressure lowering effects of beetroot juice in small number of patients with inadequately treated and untreated high blood pressure for a short period of time. With a few exceptions — discussion of potential costs and harms did not meet our standard — the findings are thoroughly covered. But we’re not sure whether to credit the story or a news release from Queen Mary University of London for this diligence. The story borrowed liberally from that release without notifying readers, and it gives the impression that these researchers were actually interviewed for the story when that wasn’t the case. We noted similar problems with a MNT story about avocados.
High blood pressure is a major risk for health complications like heart attacks, strokes, kidney disease and other conditions. Many diet and lifestyle interventions are capable of lowering blood pressure and reducing associated health risks, and beet root juice appears to be a similar option that merits further study. However, readers may want to consider the following caveats and cautions before embracing a lifetime of increased beet root juice consumption:
Overall, this study suggests that a dietary supplement may effectively lower blood pressure – an intriguing finding that warrants more work. The curious part of us wonders, How tasty is beetroot juice?
The story fails to mention costs. The cost of typical hypertension drugs is relatively well-known and the cost of beets from the neighborhood grocer, from which beetroot juice can be derived, is equally available. A well known online supplement supplier sells beet root juice for about $6 a bottle, suggesting a potential cost for the daily regimen studied here of about $3 a day, or possibly $90 a month.
The story explains that people in the experimental group who consumed the nitrate-containing beetroot juice showed a reduction of 8/4 mmHg in their blood pressure after drinking the juice. In addition, the experimental group showed as much as a 20 percent increase in blood vessel dilation, which may be helpful in reducing the risk of heart disease. No such changes appeared in those people taking the placebo. Finally, the story notes how the changes in blood pressure might be expected to influence overall cardiovascular risk: “The authors note that large-scale observational studies show that for every 2 mmHg increase in blood pressure, the risk of death from heart disease goes up 7% and from stroke by 10%.”
It may be reasonable to think that taking large amounts of nitrates for long periods of time is safe, but are we really sure? It’s perhaps also worth mentioning that people should get their nitrate from foods, not supplements. Cases in the medical literature have documented confusion between inorganic nitrate (found in beets) and synthetic organic nitrate or nitrite (e.g. nitroglycerin or amyl nitrate). The latter agents cause potent dilation of the blood vessels at low doses and can precipitate fatal cardiovascular collapse.
The story points to the double-blind, placebo-based nature of the trial meaning patients and researchers were unaware of which version of the juice they were taking. One can check to see how good the blinding is by asking patients to guess. (It’s not clear if that was done here.) In addition, the blood pressure in subjects in the experimental group rose again to previous high levels once they stopped drinking the beetroot juice. The story also states that the study was published in a peer-reviewed journal, and was admittedly small and of short duration. Together, this suggests an adequate explanation of the quality of the evidence provided by the study.
High blood pressure is common, and lowering blood pressure may decrease future risk of stroke and heart attack. But we do question this story’s suggestion that a mere 8/4 mmHg reduction could make someone’s blood pressure levels “normal” or that these participants’ blood pressure was “not controlled” at the higher level. We’ll give the benefit of the doubt, but medicalizing blood pressure levels that fall slightly outside a somewhat arbitrary “normal” range raises disease-mongering concerns.
The story offers comments from only two sources: One, a research leader at the British Heart Foundation, which funded the study, and the second, the apparent principal investigator conducting the trial. The story borrows liberally from a news release (more on that later) and offers no insight from individuals not connected to the project.
The story does make the point (through a quote borrowed directly from a news release) that for some high blood pressure patients, complying with daily doses of drugs to combat their condition, “when they feel ok,” presents a major problem, and therefore, obtaining the same therapeutic outcome though eating specific foods would be “hugely beneficial.” The story also notes that there are other sources of dietary nitrate other than beet juice, including leafy greens such as lettuce and cabbage.
We’ll award a satisfactory here, but we note that the story could have mentioned several other dietary approaches that are also associated with lowering of blood pressure. The best known are lowering sodium intake and the related “DASH diet.” Weight loss and exercise are also among the range of blood pressure-lowering alternatives.
The story could have mentioned options for purchasing or preparing beet juice. While it didn’t emphasize this or discuss the availability of beets or other nitrate-containing vegetables, we think most readers will understand that these foods and juices are available.
The story notes that the new study builds on previous research by this team, and a quick search confirms that these researchers were among the first to investigate the blood pressure effects of beet juice.
This story relies heavily on a news release from the Queen Mary University of London but fails to attribute complete quotes and other information to that news release. In several instances, release quotes are verbatim; in others, release material is only slightly altered. Material taken from news releases should always be attributed to such releases to avoid the readers’ assumption that the writer actually interviewed the sources involved. That wasn’t done for this story.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
Comments (1)
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shaun nerbas
January 26, 2015 at 12:40 pmI’m glad I read your article. About 2 weeks ago I saw the story about beet root juice on the internet, and went to the local grocery store to see what they were selling. I just found one expensive jar of juice with a
lot of sugar in it , so I passed on it . I eat a lot of home cooked beets that the mother in law makes for me, in the pressure cooker ( she loves to cook ). I’ll stick to that.
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