A growing body of research suggests that beetroots can help lower a person’s blood pressure. Researchers believe that this is due to their nitrate content. Hypotensive effect of beetroot seems to be highly influenced by physiological and medical status. Beetroot juice administration was found to exert a much stronger effect on blood pressure in hypertensive compared to normotensive subjects, which can be explained by the rate of erythrocyte xanthine oxidase expression (XOR - Erythrocytic Xanthine Oxidoreductase, an enzyme involved in reduction of NO 2 in active NO) in hypertensive states [ 40]. Jones-Carson J, Vazquez-Torres A, van der Heyde HC, Warner T, Wagner RD, Balish E. Gamma delta T cell-induced nitric oxide production enhances resistance to mucosal candidiasis. Nat Med. 1995;1(6):552–7. The results suggest that supplementing the levels of nitrate in the diet can be simple and effective way to manage high blood pressure. But a study on many more patients is needed before this approach can become a recommended treatment for high blood pressure. Getting the most from your veg Vanhatalo et al. have performed one of the leading human studies on the connection between the nitrate-responsive oral microbiome and nitric oxide (NO) homeostasis, which have revealed a positive relationship between nitrate- nitrite pathway on microbiome action and salivary flow rate. Nevertheless, it is still in doubt, how the abundance of known NO 3- reducing bacteria such as Fusobacterium nucleatum, Prevotella melaninogenica and Leptorichia buccalis affects nitrate response. NO biomarkers, including the blood pressure and arterial stiffness, have been used to express the results. The NO 3 and NO 2 values were seen to be significantly higher in the beetroot juice supplemented group than the control. The results have also explained no considerable SBP and DBP modulations comparing to the baseline, notwithstanding a non- significant difference to be present among older subjects, due to the higher NO 2 concentration in that group following beetroot juice consumption. The high baseline abundance of Fusobacterium nucleatum subsp. vincentii and nucleatum among other oral bacteria reduced blood pressure as a physiological response to beetroot juice supplementation as the phyla that possess a non-significant lower availability following beetroot juice consumption comparing to placebo [ 61]. Based on this article, the chronic ingestion of inorganic NO 3 not only increases a proportion of the oral microbiome including Bacteroidetes, Firmicutes and Fusobacteria, but also serves to change the relative abundance of a few, but not all, NO 3- reducers. This alteration is positive in Neisseria and Rothia reducers, due to the high NO bioavailability, as a probable cardiovascular health promoter, and negative among Prevotella and Veillonella. Authors concluded that dietary NO 3 supplementation could alter the salivary microbiome in young and old normotensive individuals [ 61].

Beetroot juice is the original formulation for dietary NO 3 − supplementation [ 3, 11] and has been applied as a prime for most novel formulations proposed in recent years, according to the aim of the pre-clinical or clinical studies and to the volunteer population to be tested. Fresh and concentrated beetroot juice is produced from beets after mixing in a food centrifuge processor without adding water. In placebo-controlled studies, depleted NO 3 − beetroot juice was obtained by the removal of NO 3 − by anion-exchange chromatography using PuroliteA-520E resin. Depleted-NO 3 − juice displays similar sensory characteristics and is indistinguishable in color, taste, appearance, and texture from NO 3 −-rich beetroot juice. Bondonno CP, Liu AH, Croft KD, Considine MJ, Puddey IB, Woodman RJ, et al. Antibacterial mouthwash blunts oral nitrate reduction and increases blood pressure in treated hypertensive men and women. Am J Hypertens. 2014;28(5):572–5. Abiotic conditions, such as atmospheric humidity, extreme temperatures, low and high, exposure time to sunlight, and brightness can affect NO 3 − accumulation in vegetables, although some agricultural management aspects, such as farming systems, soil fertilization, nutrient availability, and herbicide use must be considered to achieve this crop’s growth and development [ 16]. Clifford T, Howatson G, West D, Stevenson E. The potential benefits of red beetroot supplementation in health and disease. Nutrients. 2015;7(4):2801–22.

How to Use Beetroot Juice

Shepherd AI, Wilkerson DP, Dobson L, Kelly J, Winyard PG, Jones AM, et al. The effect of dietary nitrate supplementation on the oxygen cost of cycling, walking performance and resting blood pressure in individuals with chronic obstructive pulmonary disease: a double blind placebo controlled, randomised control trial. Nitric Oxide. 2015;48:31–7. The unsustain blood pressure lowering properties, is another substantial topic. A randomized parallel, clinical trial by Jajja et al. among overweight older adults, revealed a progressive decline in SBP measurements following a 3 week beetroot juice supplementation, which returned to the baseline 1 week post-intervention; accordingly, it was concluded that continuous beetroot supplementation might be necessary to sustain beneficial cardiovascular effects [ 31]. AB - The aim of the current study was to determine the effects of dietary nitrate ingestion on parameters of sub- maximal and supramaximal exercise and time trial (TT) performance in trained kayakers. Eight male kayakers completed four exercise trials consisting of an initial discontinuous graded exercise test to exhaustion and three performance trials using a kayak ergometer. The performance trials were composed of 15 min of paddling at 60% of maximum work rate, five 10-s all-out sprints, and a 1 km TT. The second and third trials were preceded by ingestion of either 70 ml nitrate-rich concentrated beetroot juice (BR) or tomato juice (placebo [PLA]) 3 hr before exercise using a randomized crossover design. Plasma nitrate (PLA: 33.8 ± 1.9 ?M, BR: 152 ± 3.5 ?M) and nitrite (PLA: 519.8 ± 25.8, BR: 687.9 ± 20 nM) were higher following ingestion of BR compared with PLA (both p < .001). VO2 during steady-state exercise was lower in the BR trial than in the PLA trial (p = .010). There was no difference in either peak power in the sprints (p = .590) or TT performance between conditions (PLA: 277 ± 5 s, BR: 276 ± 5 s, p = .539). Despite a reduction in VO2, BR ingestion appears to have no effect on repeated supramaximal sprint or 1 km TT kayaking performance. A smaller elevation in plasma nitrite following a single dose of nitrate and the individual variability in this response may partly account for these findings.

Joris PJ, Mensink RP. Beetroot juice improves in overweight and slightly obese men postprandial endothelial function after consumption of a mixed meal. Atherosclerosis. 2013;231(1):78–83. Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr. 2013;143(6):818–26. Phytochemicals give plants their color and flavor. They also stimulate the immune system, minimize inflammation, and reduce oxidative stress. Phosphoric acid and citric acid are predominant in beetroot juice, followed by oxalic acid and malic acid. Subsequently, shikimic acid, the precursor for the synthesis of aromatic amino acids such as phenylalanine, tyrosine and tryptophan, and betalains, are detected in high concentrations in organic and conventional farming beets, while citric acid, malic acid, and fumaric acid are also observed, but at lower concentrations [ 39]. Malic acid is present at the highest concentrations in beetroot formulations, including juice, chips, powder, and cooked vegetables, followed by citric acid and ascorbic acid [ 18]. Hobbs DA, Kaffa N, George TW, Methven L, Lovegrove JA. Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects. Br J Nutr. 2012;108(11):2066–74.The potential interaction of NO 3- rich beetroot juice with phosphodiesterase-5 inhibitors and consequent severe hypotension, is another consideration. Beneficial properties of beetroot can be profoundly affected by medications imposing undesirable interaction with metabolism and the ultimate metabolic pathways of NO 3/ NO 2; as such, the hypotensive effect of orally ingested NO 2 is proposed to be abolished by esomeprazole, a proton pump inhibitor [ 18]. The possibility of using a natural product, rather than another pill, to help lower blood pressure, is very appealing Dr Shannon Amoils Beetroot-cereal bar, gel, and chips can be classified as dietary fiber sources, since they contain over 3% ( w/w) fibers, in accordance with the Brazilian legislation [ 29]. Beetroot-cereal bars presented the highest total dietary fibers due to the addition of cereals—oat and rice—that contribute not only to dietary fiber but also enhance protein content and phytochemical concentrations and diversity. As widely recognized, a high dietary fiber intake decreases blood cholesterol levels, by increasing bile acid production or short-chain fatty acid synthesis, and inactivates pathogenic bacteria, while stimulating the proliferation of benefic bacterial flora that, in turn, boosts the immune system and prevents and manages gastrointestinal tract infections. Domínguez R, Cuenca E, Maté-Muñoz J, García-Fernández P, Serra-Paya N, Estevan M, et al. Effects of beetroot juice supplementation on cardiorespiratory endurance in athletes. A systematic review. Nutrients. 2017;9(1):43. Discard the pulp and pour the beetroot juice into a glass. Chill it in the refrigerator or serve it straight away.

As a counterpoint, despite elevations in plasma NO 2 concentration, no significant decrease of blood pressure has been admitted in diabetic patients supplemented with 250 mL beetroot juice for 2 weeks. The reason for this discrepant result is unclear but may reflect the study methodology, related to concomitant medications or aberrant vascular physiology in diabetic patients [ 28].Kapadia GJ, Azuine MA, Sridhar R, Okuda Y, Tsuruta A, Ichiishi E, et al. Chemoprevention of DMBA-induced UV-B promoted, NOR-1-induced TPA promoted skin carcinogenesis, and DEN-induced phenobarbital promoted liver tumors in mice by extract of beetroot. Pharmacol Res. 2003;47(2):141–8.

A large body of epidemiological evidence and meta-anal

What is it?

Another small-scale study showed that drinking 250 ml of beetroot juice every day for 4 weeks lowered blood pressure among people with hypertension. Additionally, the oxalic acid constitution of beetroot is relatively abundant [ 13]; average content in raw beetroot and beetroot juice equals to 94.6–141.6 mg/100 g and 300–525 mg/L, respectively. Oxalic acid, as a metal ion chelator, promotes the formation of nephroliths, and therefore, is considered as a health concern especially in patients predisposed to the kidney disease [ 1, 14]. Subsequently, it is important to ascertain the probable interactions between beetroot juice and various supplements of proven ergogenic effects such as caffeine, creatinine, β-alanine, and sodium bicarbonate, and assure the possible beneficial impacts [ 7]. Holmes RP, Assimos DG. The impact of dietary oxalate on kidney stone formation. Urol Res. 2004;32(5):311–6.