The BEETing of your Heart

An informational Newsletter about Beneficial Beets and Heart Health by Annabel Rusoff
Lehman College Dietetic Internship, February 2017

The benefits of beets - both roots and greens - are manifold, and the simple beet
is more popular than ever. Beets continue to become more mainstream, and a variety of
beet preparations - beet juices, beet chips, pickled beets, beet hummus, and fermented
beet products are increasingly prevalent in the supermarket aisles. Beet roots are not
only a great source of fiber, folate, potassium, manganese, vitamin C, and iron, they
also contain polyphenols, phytosterols, and are abundant in nitrates, all of which have
been shown to protect the heart.
Beets come in many varieties: white, yellow, pink, spiraled red and white, and of
course, the traditional and most commonly seen Beta vulgaris L., or red beet root (1). It
is this variety of beet which has been studied most.
The pigments which make Beta vulgaris L. that unmistakable, gorgeous, deep
red color are called betalains, which are polyphenols (natural chemicals which have
antioxidant properties (2)). Recent studies have shown that betalains can lower cancer
risk and/or slow cancer progression (3, 4, 6). Belatains have also been shown to be anti-
inflammatory agents which can lower risk of many chronic diseases and contribute to
overall optimal health (6). A specific form of betalain called betanin - which is abundant
in red beet roots - protects LDL cholesterol from oxidation, consequently reducing the
risk of cardiovascular disease (3,5). Red beets also contain phytosterols, chemical
structures found in plants very similar to cholesterol, which can help lower the body's
cholesterol levels by promoting cholesterol excretion, also decreasing risk of
cardiovascular disease.
Beets can also help with blood pressure. Beet roots contain a significant number
of nitrates (NO3) which can be converted to nitrites (NO2) and further converted to nitric
oxide (NO) in the body. Nitric oxide signals blood vessels to dilate, thereby lowering
blood pressure (8,9,11). Clinical studies and meta analyses have repeatedly found that
ingesting beets causes a significant decrease in both systolic and diastolic blood
pressure as well as increased dilation of blood vessels. (6, 7,10,11,13).
Higher levels of nitrites are associated with increased physical activity endurance
(6), and beet root ingestion has specifically been linked to improved running

performance (15) and aerobic endurance (17). Since exercise is the very best way to
protect your heart, endurance adds to nitrates' cardio-protective effects.
As previously mentioned, beet roots are an excellent source of potassium, a
macronutrient needed for muscle contractions, therefore essential for a healthy
heartbeat. Potassium is a main component of the Dietary Approaches to Stop
Hypertension (DASH) diet and is readily recommended to patients with hypertension.
Potassium also helps the body void excess sodium through urine and reduces tension
in blood vessels. Both mechanisms reduce blood pressure and contribute to a happy,
healthy heart (12).
The BEETing of your Heart
An informational Newsletter about Beneficial Beets and Heart Health by Annabel Rusoff
Lehman College Dietetic Internship, February 2017

HOW TO ENJOY THE BENEFICIAL BEET

No matter how you slice, dice, shred, or juice them, beets are hard to beat! To
get the most out of beets, raw beet root juice has been shown to have the most
beneficial effects with all their nutrients intact (13). If you don't like raw beets, don't fret.
Cooked, fermented, or pickled beets retain much of their nutritious value, although
some of the nitrites and other nutrients may be lost during preparation (13, 18, 19, 20).
Canned and pickled beets likely contain high amounts of sodium, so if it's heart health
you're after, these choices should be limited. Current research shows little difference in
chemical composition between organic and conventional beet roots (16), so that choice is
up to you.
Whichever variety you choose, be warned that beet pigments are also an
excellent dye. They'll stain your hands (and everything else), so wearing gloves is a
good idea. If your urine turns red after eating beets, don't worry! This is a common after-
effect of beet ingestion called beeturia (21).
And don't forget the beet greens, which are also exceptional for your health, but
that's another story for a different day.

References:
(1) USDA Natural Resources Conservation Service - Plant Classifications:
http://plants.usda.gov/java/ClassificationServlet?source=display&classid=BEVM2

(2) Merriam Webster Dictionary

https://www.merriam-webster.com/dictionary/polyphenol

(3) Esatbeyoglu, T., Wagner, A. E., Schini-Kerth, V. B., & Rimbach, G. (2014). Betanin- A food
colorant with biological activity. Molecular Nutrition & Food Research, 59(1), 36-47.
doi:10.1002/mnfr.201400484

(4) Esatbeyoglu, T., Wagner, A. E., Motafakkerazad, R., Nakajima, Y., Matsugo, S., &
Rimbach, G. (2014). Free radical scavenging and antioxidant activity of betanin:
Electron spin resonance spectroscopy studies and studies in cultured cells. Food
and Chemical Toxicology, 73, 119-126. doi:10.1016/j.fct.2014.08.007

(5) Tesoriere, L., Allegra, M., Butera, D., Livrea, M.A. (2004). Absorption, excretion, and
distribution of dietary antioxidant betalains in LDLs: Potential health effects of
betalains in humans. Am. J. Clin. Nutr, 80(4), 941-5.

(6) Clifford, T., Howatson, G., West, D., & Stevenson, E. (2015). The Potential Benefits of Red
Beetroot Supplementation in Health and Disease. Nutrients, 7(4), 2801-2822.
doi:10.3390/nu7042801

(7) Hobbs, D. A., Kaffa, N., George, T. W., Methven, L., & Lovegrove, J. A. (2012). Blood
pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products
in normotensive male subjects. British Journal of Nutrition, 108(11), 2066-2074.
doi:10.1017/s0007114512000190
The BEETing of your Heart
An informational Newsletter about Beneficial Beets and Heart Health by Annabel Rusoff
Lehman College Dietetic Internship, February 2017
(8) Kapil, V., Milsom, A. B., Okorie, M., Maleki-Toyserkani, S., Akram, F., Rehman, F., . . .
Ahluwalia, A. (2010). Inorganic Nitrate Supplementation Lowers Blood Pressure in
Humans: Role for Nitrite-Derived NO. Hypertension, 56(2), 274-281.
doi:10.1161/hypertensionaha.110.153536

(9) Webb, A. J., Patel, N., Loukogeorgakis, S., Okorie, M., Aboud, Z., Misra, S., . . .
Ahluwalia, A. (2008). Acute Blood Pressure Lowering, Vasoprotective, and
Antiplatelet Properties of Dietary Nitrate via Bioconversion to Nitrite. Hypertension,
51(3), 784-790. doi:10.1161/hypertensionaha.107.103523

(10) Siervo, M., Lara, J., Ogbonmwan, I., & Mathers, J. C. (2013). Inorganic Nitrate and
Beetroot Juice Supplementation Reduces Blood Pressure in Adults: A Systematic
Review and Meta-Analysis. Journal of Nutrition, 143(6), 818-826.
doi:10.3945/jn.112.170233

(11) Webb, A. J., Patel, N., Loukogeorgakis, S., Okorie, M., Aboud, Z., Misra, S., . . .
Ahluwalia, A. (2008). Acute Blood Pressure Lowering, Vasoprotective, and
Antiplatelet Properties of Dietary Nitrate via Bioconversion to Nitrite. Hypertension,
51(3), 784-790. doi:10.1161/hypertensionaha.107.103523

(12) American Heart Association - How potassium can help lower blood pressure
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTrea
tmentofHighBloodPressure/How-Potassium-Can-Help-Control-High-Blood-
Pressure_UCM_303243_Article.jsp#.WGqe8rE-KqA

(13) Asgary, S., Afshani, M. R., Sahebkar, A., Keshvari, M., Taheri, M., Jahanian, E., . . .
Sarrafzadegan, N. (2016). Improvement of hypertension, endothelial function and
systemic inflammation following short-term supplementation with red beet (Beta
vulgaris L.) juice: a randomized crossover pilot study. Journal of Human Hypertension,
30(10), 627-632. doi:10.1038/jhh.2016.34

(14) Vahora, H., Khan, M. A., Alalami, U., & Hussain, A. (2016). The Potential Role of Nitric
Oxide in Halting Cancer Progression Through Chemoprevention. Journal of Cancer
Prevention, 21(1), 1-12. doi:10.15430/jcp.2016.21.1.1

(15) Murphy, M., Eliot, K., Heuertz, R. M., & Weiss, E. (2012). Whole Beetroot Consumption
Acutely Improves Running Performance. Journal of the Academy of Nutrition and
Dietetics, 112(4), 548-552. doi:10.1016/j.jand.2011.12.002

(16) Kazimierczak, R., Hallmann, E., Lipowski, J., Drela, N., Kowalik, A., Püssa, T., . . .
Rembiałkowska, E. (2014). Beetroot ( Beta vulgaris L.) and naturally fermented
beetroot juices from organic and conventional production: metabolomics, antioxidant
levels and anticancer activity. Journal of the Science of Food and Agriculture, 94(13),
2618-2629. doi:10.1002/jsfa.6722

(17) Eggebeen, J., Kim-Shapiro, D. B., Haykowsky, M., Morgan, T. M., Basu, S., Brubaker, P., .
. . Kitzman, D. W. (2016). One Week of Daily Dosing With Beetroot Juice Improves
Submaximal Endurance and Blood Pressure in Older Patients With Heart Failure
The BEETing of your Heart
An informational Newsletter about Beneficial Beets and Heart Health by Annabel Rusoff
Lehman College Dietetic Internship, February 2017
and Preserved Ejection Fraction. JACC: Heart Failure, 4(6), 428-437.
doi:10.1016/j.jchf.2015.12.013

(18) Nutritiondata.com - Raw Beet Roots

http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2348/2

(19) Nutritiondata.com - Cooked beet roots, boiled with water, drained

http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2349/2

(20) Nutritiondata.com - Beets pickled, canned, solids and liquids

http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2730/2

(21) Watts, A. R., Lennard, M. S., Mason, S. L., Tucker, G. T., & Woods, H. F. (1994).
Beeturia and the biological fate of beetroot pigments. Pharmacogenetics, 3(6), 302-
311. doi:10.1097/00008571-199312000-00004