Beetroot
Beetroot (usually as juice) is a supplement with a high nitrate content that is said to improve physical performance secondary to nitric oxide. It appears to have some evidence for this claim in healthy athletes.
Beetroot is most often used for
Last Updated:August 21, 2023
Beetroot appears to reduce blood pressure in instances where blood pressure is raised. This appears to occur in people with hypertension and can occur in otherwise healthy persons undergoing exercise.
Beetroot can improve exercise performance in various different contexts. In general it seems to reduce fatigue with continued muscle contractions and may therefore have most benefit during anaerobic cardiovascular exercise or muscular endurance events (e.g., sports with anaerobic intervals such as hockey, rugby, and crossfit-type exercises). Beetroot also seems to benefit exercise performance during prolonged endurance exercise, albeit seemingly to a small degree.
Beetroot may be beneficial for oral health. Beetroot does not appear to improve insulin sensitivity or cognitive function. Currently, there's no research on whether it's beneficial for erectile dysfunction.
Beetroot is high in oxalate, meaning it could increase the risk of oxalate-based kidney stones in susceptible individuals.
The nitrate content of beetroot is theoretically a concern because nitrate can lead to the formation of compounds called nitrosamines, some of which are carcinogenic. However, observational evidence largely does not support a link between vegetable-derived nitrate intake and cancer risk.
Because nitrate can cause blood vessels to dilate, it’s possible some people may experience headaches following beetroot ingestion.
Beetroot can cause stool and urine to develop a red or pink color in the hours to days following ingestion. This condition is benign but the coloration may resemble blood, which could be alarming.
Most of beetroot's effects are by providing nitrate, which can be converted into nitric oxide. Nitric oxide can induce vasodilation (expansion of blood vessels), thereby lowering blood pressure. The vasodilatory effect of nitric oxide also increases blood flow — and thus oxygen and nutrient delivery — to muscles, improving exercise performance. Additionally, nitric oxide seems to enhance muscle contraction and cellular energy efficiency.
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Beetroot tends to be dosed on the nitrate content, with around 0.1-0.2mmol/kg (6.4-12.8mg/kg) being the target for nitrate. This is about 436mg for a 150lb person, which is comparable to half a kilogram (500g) of the beetroots themselves (wet weight).
Consumption of beetroots for the nitrate content can be either via a puree or smoothie, or the beets themselves can be baked in an oven into chips. The aforementioned cooking techniques do not appear to reduce the nitrate content.
Although the food products that contain nitrates differ widely, the nitrates present in processed meats and vegetables are chemically identical.
From an epidemiological perspective, nitrates are commonly thought to be adverse to health due to a long-standing restriction on how much nitrate can be in drinking water (50mg/L) or ground water (due to accumulating in vegetables) due to the risk of infantile methemoglobinemia (baby blue syndrome)[reference|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525621/|title=Survey of Literature Relating to Infant Methemoglobinemia Due to Nitrate-Contaminated Water][reference|url=http://jama.jamanetwork.com/article.aspx?articleid=366259|title=Cyanosis in Infants Caused by Nitrates in Well Water] which does appear to apply to vegetables.[reference|url=http://www.ncbi.nlm.nih.gov/pubmed/10615207|title=Dietary nitrate in man: friend or foe|published=1999 May|authors=McKnight GM, Duncan CW, Leifert C, Golden MH|journal=Br J Nutr][reference|url=http://www.ncbi.nlm.nih.gov/pubmed/21075182|title=Vegetable-borne nitrate and nitrite and the risk of methaemoglobinaemia|published=2011 Jan 15|authors=Chan TY|journal=Toxicol Lett] More commonly, the association between processed meat products that are pink in color (which very commonly use sodium nitrate as a preservative) and cancer occurrence also paints nitrates in the same negative light.[reference|url=http://www.biomedcentral.com/1741-7015/11/63|title=Meat consumption and mortality - results from the European Prospective Investigation into Cancer and Nutrition] Conversely, vegetables are commonly stated to not be associated with cancer risk (which then raises concern about whether or not they are the same molecules).
Both consumption of vegetables (most commonly researched is beetroot[reference|url=http://www.ncbi.nlm.nih.gov/pubmed/23640589|title=Beetroot juice and exercise: pharmacodynamic and dose-response relationships|published=2013 May 2|authors=Wylie LJ, Kelly J, Bailey SJ, Blackwell JR, Skiba PF, Winyard PG, Jeukendrup AE, Vanhatalo A, Jones AM|journal=J Appl Physiol]) and consumption of the sodium nitrate preservative cause increases in serum nitrate and nitrite, and are considered bioequivalent. In some studies that assess nitrate's bioactivity, liquid solutions of sodium nitrate are even used.[reference|url=http://www.ncbi.nlm.nih.gov/pubmed/19913611|title=Dietary nitrate reduces maximal oxygen consumption while maintaining work performance in maximal exercise|published=2010 Jan 15|authors=Larsen FJ, Weitzberg E, Lundberg JO, Ekblom B|journal=Free Radic Biol Med][reference|url=http://www.ncbi.nlm.nih.gov/pubmed/21276184|title=Nitrite supplementation reverses vascular endothelial dysfunction and large elastic artery stiffness with aging|published=2011 Jun|authors=Sindler AL, Fleenor BS, Calvert JW, Marshall KD, Zigler ML, Lefer DJ, Seals DR|journal=Aging Cell][reference|url=http://www.ncbi.nlm.nih.gov/pubmed/19913611|title=Dietary nitrate reduces maximal oxygen consumption while maintaining work performance in maximal exercise|published=2010 Jan 15|authors=Larsen FJ, Weitzberg E, Lundberg JO, Ekblom B|journal=Free Radic Biol Med]
There are still differences between eating processed meat and vegetables in this regard (intake of sodium through the preservative sodium nitrate and higher intake of potassium via vegetables; less conversion of nitrate into nitrosamines with coingested antioxidants) but the molecule itself is the same.