Atrium Health Carolinas Medical Center

After women go through menopause, their risk of heart disease increases dramatically. Researchers studied whether beetroot juice, which is rich in nitrate, can improve how blood vessels function. The results showed that daily consumption of beetroot juice by postmenopausal women may improve blood vessel function enough to reduce future heart disease risk. After women go through menopause, their risk of heart disease increases dramatically. To improve and support heart and blood vessel health among postmenopausal women, researchers at Penn State studied whether beetroot juice can improve how blood vessels function. Results published today (June 10) in Frontiers in Nutrition indicated that daily consumption of beetroot juice by postmenopausal women may improve blood vessel function enough to reduce future heart disease risk. Beetroot juice contains high levels of nitrate, which the body converts to nitric oxide. Nitric oxide helps blood vessels expand, making it easier for blood to flow through the circulatory system. The ability of nitric oxide to widen blood vessels is known to be particularly helpful during periods of limited blood flow and oxygen delivery, such as during a heart attack, according to the researchers. David Proctor, professor of kinesiology and physiology at Penn State, and Jocelyn Delgado Spicuzza, who earned her doctorate in integrative and biomedical physiology from Penn State in May, led an interdisciplinary team of researchers who tested how nitrate-rich beetroot juice impacted blood vessel health in 24 postmenopausal women in their 50s and 60s. "After menopause, women no longer produce estrogen, which helps maintain nitric oxide in the body," said Delgado Spicuzza, first author of the research and current SAFE-T center research project manager. "This loss of nitric oxide production contributes to the substantial increase in heart disease risk for postmenopausal women. Foods that are rich in nitrate -- especially beets -- are being investigated as a natural, non-pharmaceutical way to protect the heart and blood vessels." Nitrate is an approved food additive for some animal-based food products, such as processed meats. However, nitrate food additives and preservatives are strictly regulated due to their potential to cause cancer, according to Delgado Spicuzza. In contrast, plants like beets, spinach and lettuce naturally accumulate nitrate from the soil. These plant-based sources of nitrate have cardiovascular benefits because the human body can convert nitrates from plants to nitric oxide, which it cannot do with nitrate added to meats. In this study, participants had their vascular function tested at the Penn State Clinical Research Center and then consumed two 2.3-ounce bottles of beetroot juice as an initial dose, followed by one bottle every morning for a week. All participants consumed concentrated beetroot juice, with each serving providing as much nitrate as three large beets. A few weeks later, the participants drank beetroot juice with the nitrate removed. Neither the researchers nor the participants knew which juice was being consumed at the time of testing. A day after their last dose, participants returned for testing of their vascular function. The researchers compared how well blood vessels expanded for each woman when they were and were not consuming the nitrate-rich beetroot juice. The researchers used an ultrasound sensor to monitor how blood flowed through the brachial artery -- which is in the upper arm and supplies blood to the hands -- during a stress test in which blood flow was restricted in each participant's forearm for five minutes. When the restriction was removed, researchers measured how blood flow changed in the brachial artery again. The results showed that consumption of nitrate-rich beetroot juice each day improved blood flow compared to when the participants drank nitrate-free beetroot juice. The researchers said that this level of improved blood-vessel function -- if it could be maintained over the postmenopausal years -- could significantly reduce the risk of heart disease. They said that long-term health benefits of beetroot juice have not been studied at this point, but the long-term benefits of nitrate-rich vegetables have been confirmed. "Women may need to consume beetroot juice daily -- or even more often -- to experience all of the potential cardiovascular benefits," Proctor said. "Still, this research shows that beetroot juice can be very useful in protecting blood vessel health of mid-life women during a period of accelerating heart disease risk." This study included women considered early postmenopausal, or one to six years post-menopause, and late postmenopausal, six or more years post-menopause. Late postmenopausal women saw the same benefits as the early postmenopausal group. Delgado Spicuzza said the research team was particularly excited to find that beetroot juice improved blood vessel health for women who had gone through menopause years earlier. Some treatments for protecting cardiovascular health in postmenopausal women -- like hormone therapy -- are only safe during the first several years post-menopause. After that, hormone therapy can increase the risk of cancers and stroke. "Some clinicians are already recommending beetroot juice to men and women with high blood pressure," Delgado Spicuzza said. "By providing a safe and effective way to improve blood vessel function, beets could help maintain cardiovascular health in postmenopausal women. When you consider that most women are postmenopausal for at least a third of their lives, you can begin to understand the potential significance of these results." Delgado Spicuzza won the Mid-Atlantic American College of Sports Medicine 2023 Doctoral Student Investigator Award for her presentation on this research in fall of 2023. She said it is gratifying to see this research resonate with other researchers and especially with the women in the study, who seemed to embrace the potential of beetroot juice. "Several of the participants said that they intended to continue consuming beetroot juice after the study concluded," she said. "There seems to be a real desire on the part of postmenopausal women to support their cardiovascular health without taking additional medications. In part, I believe beets can be a complementary food to improve blood vessel health in millions of women as they age." Jigar Gosalia, graduate student in kinesiology at Penn State; Mary Jane De Souza, distinguished professor of kinesiology and physiology at Penn State; Kristina Petersen, associate professor of nutritional sciences at Penn State; Michael Flanagan, doctor of family medicine at Penn State Health; Liezhou Zhong, postdoctoral research fellow in the School of Medical and Health Science at Edith Cowan University in Australia; Catherine Bondonno, senior research fellow in the School of Medical and Health Science at Edith Cowan University in Australia; Elmira Alipour, clinical research coordinator at Atrium Health Carolinas Medical Center; Daniel Kim-Shapiro, professor of physics and Harbert Family Distinguished Chair for Excellence in Teaching and Scholarship at Wake Forest University; and Yasina Somani, assistant professor of exercise physiology at the University of Leeds in the United Kingdom, all contributed to this research. The researchers said they are grateful to Cyndi Flanagan and Christa Oelhaf, nurses in the Clinical Research Center, for their contributions to this research. This research was funded by the National Institutes of Health and the Huck Endowment for Nutritional Research in Family and Community Medicine at Penn State College of Medicine and University Park.

CHARLOTTE, N.C. & LITTLETON, Mass.--( BUSINESS WIRE )-- Atrium Health Levine Cancer achieved a groundbreaking milestone with the delivery and start of installation of a state-of-the-art proton accelerator unit. Weighing in at 15 tons, this crucial piece of equipment will serve as the powerhouse for proton beam therapy at the Atrium Health Levine Cancer Proton & Advanced Radiation Center , upon completion of installation next year. Proton beam therapy targets radiation precisely to a tumor, leaving the areas around it unharmed. It’s been used clinically for more than 60 years and has been proven to be safe, effective and to improve the quality of life for patients. It is not widely available, however, due to the expertise, expense and space it requires for hospitals to install and maintain. By providing this powerful treatment in Charlotte, adult patients at Levine Cancer and pediatric patients at Atrium Health Levine Children’s will be able to receive this advanced therapy close to home. “This is one of the final steps in completing the Atrium Health Levine Cancer Proton and Advanced Radiation Center,” said Dr. Ruben Mesa , president of Atrium Health Levine Cancer. “It will play a pivotal role in advancing cancer care for patients across the region. This cutting-edge technology will enhance patient outcomes and provide hope to many families who would have to travel outside of Charlotte to receive these life saving treatments.” “We congratulate Atrium Health for becoming the first in the Carolinas, and one of only a small number of health systems, nationwide, to offer this cutting-edge therapy,” said Tina Yu, president and CEO of Mevion Medical Systems , which manufactures the proton therapy equipment. “Mevion transformed radiation oncology by inventing compact proton therapy. With this technology, Atrium Health will be able to offer its patients this ideal treatment for many types of tumors, especially tumors in sensitive locations of the body and in pediatric patients.” The accelerator unit – the engine of the proton center – was delivered on Saturday, Dec. 9, on the campus of Atrium Health Carolinas Medical Center, where Levine Cancer is based. The unit traveled 900 miles from Mevion headquarters in Littleton, Massachusetts, via delivery truck on a trailer. Upon arrival at the building in which the unit will be housed, the accelerator was hoisted via a crane into the building. In addition to proton beam therapy, the Proton and Advanced Radiation Center will also soon offer gamma knife radiosurgery, a unique technology that targets brain lesions that are difficult to treat through surgery or radiation due to their location. Like proton therapy, gamma knife radiosurgery delivers targeted radiation with extreme precision, leaving very few effects on the tissue around it. It is done entirely as an outpatient procedure and doesn’t require an incision or general anesthesia. While it can treat other conditions of the brain, gamma knife radiosurgery’s most common use is for brain metastases. The Atrium Health Levine Cancer Proton and Advanced Radiation Center will be open to patients before the end of 2023, first offering gamma knife radiosurgery treatments, followed in mid-to-late 2024 by proton beam therapy sessions. When all services are available to patients, the Atrium Health Levine Cancer Proton and Advanced Radiation Center will be the only location offering proton therapy treatments between Washington, D.C., and Atlanta, and one of just 44 proton beam therapy sites in the country. About Atrium Health Atrium Health is a nationally recognized leader in shaping health outcomes through innovative research, education and compassionate patient care. Based in Charlotte, North Carolina, Atrium Health is part of Advocate Health , the third-largest nonprofit health system in the United States, which was created from the combination with Advocate Aurora Health. A recognized leader in experiential medical education and groundbreaking research, Wake Forest University School of Medicine is its academic core. Atrium Health is renowned for its top-ranked pediatric, cancer and heart care, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Atrium Health is also a leading-edge innovator in virtual care and mobile medicine, providing care close to home and in the home. Ranked nationally among U.S. News & World Report’s Best Hospitals in eight pediatric specialties and for rehabilitation, Atrium Health has also received the American Hospital Association’s Quest for Quality Prize and its 2021 Carolyn Boone Lewis Equity of Care Award, as well as the 2020 Centers for Medicare & Medicaid Services Health Equity Award for its efforts to reduce racial and ethnic disparities in care. With a commitment to every community it serves, Atrium Health seeks to improve health, elevate hope and advance healing – for all, providing $2.8 billion last year in free and uncompensated care and other community benefits. About Advocate Health Advocate Health is the third-largest nonprofit integrated health system in the United States – created from the combination of Advocate Aurora Health and Atrium Health . Providing care under the names Advocate Health Care in Illinois, Atrium Health in the Carolinas, Georgia and Alabama, and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care, with Wake Forest University School of Medicine serving as the academic core of the enterprise. Headquartered in Charlotte, North Carolina, Advocate Health serves nearly 6 million patients and is engaged in hundreds of clinical trials and research studies. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs nearly 155,000 team members across 68 hospitals and over 1,000 care locations and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to equitable care for all, Advocate Health provides nearly $6 billion in annual community benefits. About Mevion Medical Systems Mevion Medical Systems is the leading provider of compact proton therapy systems for cancer care. Dedicated to advancing the design and accessibility of proton therapy worldwide, Mevion pioneered the single-room platform and continues to further the science and application of proton therapy. Since 2013, Mevion compact proton therapy single-room systems have been used by leading cancer centers for treating patients. Mevion's series of products, including the flagship MEVION S250i and MEVION S250-FIT* with HYPERSCAN pencil beam scanning, represent the world's most compact proton therapy systems that eliminate the obstacles of size, complexity, and cost. Mevion is headquartered in Littleton, Massachusetts with a presence in Europe and Asia. For more information, please visit www.mevion.com . *The MEVION S250-FIT Proton Therapy System™ is not yet available for clinical use.