Best Foods for COPD and Peripheral Artery Disease

Image Credit: Markus Spiske / Unsplash. This image has been modified.

It’s great we can improve athletic performance by eating a few beets, but so what if you run 5% faster? It can be a fun experiment to eat a can of beets and maybe shave a minute off your 5k time, but there are people who could really benefit from a more efficient use of oxygen: those suffering from emphysema. Young, healthy adults eating greens and beets can swim, run, and cycle faster and farther, but what about those who get out of breath just walking up the stairs? Do nitrate-rich vegetables work where it counts? Yes–. Time on the treadmill in COPD pateints was significantly extended after two shots of beet juice. I discuss these benefits of nitrate-rich vegetables in my video Oxygenating Blood with Nitrate-Rich Vegetables.

Beet juice can also decrease blood pressure in young, healthy adults, but what about in those who need it––older, overweight subjects? Just one shot a day of beet juice (versus berry juice as a control) led to a significant drop in blood pressure in a few weeks. But within just a few days after stopping three weeks of beeting themselves up, blood pressure went back up. So we have to eat our vegetables and keep eating our vegetables.

Why did it take until 2015 to publish a study on using nitrates to lower blood pressure in people with high blood pressure? You’d think that’d be the first group to try it on. Who’s going to fund it, though—Big Beet? Blood pressure medications rake in more than $10 billion a year. You can’t make billions on beets.

But that’s why we have charities like the British Heart Foundation, which funded a study to give folks with high blood pressure a cup of beet juice a day for four weeks. After all, high blood pressure may be the number-one risk factor for premature death in the world. In ten years, it could affect nearly one in three adults on the planet. But put them on beet juice and blood pressures dropped and kept dropping until they stopped drinking it after a month. With so many people with high blood pressure even despite treatment, the researchers concluded, “an additional strategy, based on the intake of nitrate-rich vegetables, may prove to be both cost-effective, affordable, and favorable for a public health approach to hypertension.”

What about those with peripheral artery disease? There are tens of millions of people with atherosclerotic clogs impairing blood flow to their legs. This can cause a cramping pain in the calves called claudication, due to lack of blood flow through the blocked arteries, severely limiting one’s ability to even just walk around. But when they simply drink some beet juice, they can walk 18% longer. Researchers measured the actual oxygenation of blood within the calf muscle and found that patients were able to maintain more oxygen in their muscles after drinking beet juice.

The nitric oxide from vegetable nitrates not only improves oxygen efficiency but also oxygen delivery by vasodilating blood vessels—opening up arteries—so there’s more blood flow. I’m surprised beet juice companies aren’t trying to position themselves as veggie Viagra! It could certainly explain why those eating more veggies have such improved sexual function, though that study was a snapshot in time so technically you can’t tell whether eating veggies resulted in improved sexual function or improved sexual function led to eating more veggies. However, it seems more reasonable that low fruit and vegetable consumption contributes to erectile dysfunction, rather than the other way around.

What about the most important organ… the brain? Poor cerebral perfusion—lack of blood flow and oxygen in the brain––is associated with cognitive decline and dementia. Researchers showed that the nitrate in vegetables may be beneficial in treating age-related cognitive decline. They showed a direct effect of dietary nitrate on cerebral blood flow within the frontal lobes, the areas particularly compromised by aging. This is a critical brain area for so-called executive function, the basic task and problem solving important for day-to-day functioning. The nitrite from nitrate has been shown to not only increase blood flow to certain areas of the body but also to act preferentially in low oxygen conditions, allowing it to increase blood flow precisely in the areas where it is needed most, and that’s what they found in the brain: increased blood flow to the at-risk areas of the aging brain. The only side effect of beeting your brains out? A little extra color in your life (they noted some of the study subjects started peeing pink).


Nitrates are one of the reasons I recommend eating dark green leafy vegetables every day. See Slowing Our Metabolism with Nitrate-Rich Vegetables and “Veg-Table” Dietary Nitrate Scoring Method. Beets are another good option and not just drinking the juice; take a look at Whole Beets vs. Juice for Improving Athletic Performance.

What else can we do for high blood pressure? See the following videos:

Why is blood flow to the brain so important? I go into depth on the potential consequences in Alzheimer’s and Atherosclerosis of the Brain.

More on diet and pelvic blood flow in men can be found in:

In health,

Michael Greger, M.D.

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