Doctor's Note

The “wild ride” of which I speak is a three-week series—my longest video sequence yet—exploring this phenomenon. In Priming the Proton Pump, I’ll discuss the proposed mechanism, and then delve into the pros, cons, and controversies surrounding the performance-enhancing effects of vegetables. Strap yourself in! 

For more context, check out my associated blog posts: Using Greens to Improve Athletic PerformanceTop 10 Most Popular Videos of the YearCancer-Proofing Your BodyIncreasing Muscle Strength with FenugreekPlant-Based Diets for Rheumatoid Arthritis; and Breast Cancer & Alcohol: How Much Is Safe?

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  • Michael Greger M.D.

    The “wild ride” of which I speak is a 3-week series—my longest video sequence yet—exploring this phenomenon. In tomorrow’s video-of-the-day I’ll discuss the proposed mechanism and then delve into the pros, cons, and controversies surrounding the performance-enhancing effects of vegetables. Strap yourself in! If you don’t have the patience to wait, you can check out the DVD (all proceeds to charity) or take this opportunity to dive into any of the other thousand subjects.

  • DoctorDave

    First, thanks for all your excellent work in making top health science available to the public. Your videos have changed the way I eat and think about food as I develop optimal vegan eating. This video is very interesting but seems a little incomplete. I seem to recall that switching athletes to a vegetarian or vegan way of eating to improve endurance and recovery has been known for a long time, at least the 20’s. Also, I recall a lecture by Dr Ruth Heidrich along these lines and even that the NY Jets were using this science at one time in their training programs. What I question is what the subjects in the video were eating in addition to the beet juice? Or, is this more super-pill thinking from the establishment? That is, it’s okay to eat steak for muscle development, as long as you take your beat juice. Anyway, I’m just now rereading The China Study by Colin Campbell so maybe I’m a little extra-sensitive to this damaging approach. Have I missed the point of this video?

    • Michael Greger M.D.

      This goes beyond just beets and beyond just performance-enhancement, as you’ll see in upcoming videos (this is the first of a 17 part series!). I’m so glad you’ve found my work useful.

    • Charles

      Roman gladiators ate a vegetarian diet. I think all this has been known for a very long time. Not the specifics of why, but many of the benefits.

      • Martin351

        This is so far from the truth. The roman gladiators and soldiers ate whatever was in season and around them. It MAINLY consisted of meat from small game, a moderate amount of vegetables and segments of fruit (depending on where you were on the “importance” list).

        Your comment was 3 years ago, but it has been known for quite sometime that not only the romans of ancient times but all ancestors as well ate some form of meat.

  • BarbaraH

    I’m confused. I found the paper online here:

    I don’t speak research-ese, so I have no idea what they’re talking about. But the title is: “Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans.”

    I think I’m understanding correctly that apparently the researchers chose beets for their high nitrate content. I didn’t know this until I just looked it up and learned that nitrates form in the soil from the decomposition of nitrogen-rich waste in the soil. So vegetables, which grow in the soil, end up containing varying amounts of nitrates.

    So are these then the same nitrates we’re supposed to avoid in processed meats? Why are they helpful in one situation but harmful in another? And if it’s true that it’s the nitrates that are the critical ingredient, what different would it make if you drink beet juice or consume any other vegetable grown in nitrate rich soil?


    • Michael Greger M.D.

      You can always find links of the papers (full-text whenever available) I cite in the Sources Cited section right beneath the video. And the research-ese problem is one reason for this’s existence! Indeed it’s the nitrate content of beets and there are videos coming up exploring other vegetables and the difference between the nitrates in vegetables and the nitrites in processed meats–stay tuned Barbara!

  • BarbaraH

    Hide in plain sight! There’s so much information on every page that I have, until now, never noticed that “Sources Sited” section. Duh. Makes me wonder how much else I’m missing.


  • yummy

    What is the latest research on the connection between consuming beet juice and lower blood pressure…and is consuming dried beet juice powder (dissolved in a liquid) as effective as consuming juiced beets ?

    • Toxins

      The connection is strong! Stay tuned for this series on beet juice and other vegetables that perform even better then beets! Everything is thoroughly explained in detail.

  • amlagarlic

    having recently viewed your video on the benefits of beet juice I was hoping to clarify what the most effective way to consume beet juice would be. Such as store bought, juicing fresh beets, or by some other method. If you could let me know I would greatly appreciate it. Thank you.

  • BPCveg

    Cool study! Too bad that they didn’t test vegan borscht! Any idea as to whether we are justified in assuming that cooked beets are as effective in boosting oxygen extraction as raw beets?

  • jmerrikin

    Dr. Greger, can you tell us if this study was done with regular garden beets or sugar beets? I am hoping it was with garden variety beets as I am avoiding all GMOs.

  • jmf

    This is very interesting. I am planning a trip to Peru – elevation about 13,000ft – and I am concerned about altitude sickness. Although no one seems to know why some people get it some of the time and not other times, this nitrate/nitrite process might be the answer. I am wondering if taking a little powdered beet along that could be hydrated into juice might offer some protection. What type of juice did they use in the experiments? In general I prefer to avoid high glycemic foods, but this might be worth an exception. Do you have any suggestions on altitude sickness prevention? Thank you.

  • BarbaraH

    it’s not just beets. If you google around, you’ll see that many vegetables contain nitrates to varying degrees. It depends on the vegetable and the soil conditions. Here’s a sample list going back to 1975 from the Journal of Agricultural and Food Chemistry: I’m not trying to dispute any of what Dr. Greger is saying, but it seems from the comments that many people are misinterpreting the message.

    • Toxins

      You are correct Barbara! Stay tuned for Dr. Greger’s video that shows vegetables that do better than beets!

  • Do canned beets still have the same nitrates? Could I throw a can of beets into a blender with some hibiscus or juice to get the same result?

    • Veronica

      Tom- did you ever get an answer on this? I personally will drink blendtec’ed beet juice but for my parents I would like to make it easier and so wondering if adding canned beets to the their salads is a good idea.

  • yummy

    Taken from a popular health-promoting site, this info: Michigan State University cautions against eating too many vegetables. Vegetarians can eat up to 250mg of nitrates per day. This far exceeds the average of 75 to 100mg per day. Dr. G, can you comment on this statement so that we don’t go over-board with nitrate consumption.

    • Toxins

      Nitrates found in processed meats are different from that found in the plant world. Nitrates in processed meat converts to nitrosamines which are highly cancerous. Is this what you were referring to? Otherwise our body turns nitrates into the very helpful, nitric oxide, and excess nitrates are peed out.

      • yummy

        Toxins…I was referring to the statement, Michigan State University cautions against eating too many vegetables. I don’t eat meat, processed or otherwise, but I do eat lots of vegetables.

        • Toxins

          Could you please share the article with us? I am curious to see.

        • BarbaraH

          Yummy, I don’t know what you found specifically, but when I google MSU and nitrates I find the exact opposite information.

          What was your link? How old was it? I think for a while there was some concern by some scientists about nitrates in vegetables (judging from a quick search) but I figure those are the same scientists who once advised women not to nurse their babies.

        • Toxins

          I examined the link and its references to MSU. MSU only claimed that there were nitrates in vegetables and didn’t discuss the health detriments. Colorado state university had more to say.

          The only concern they pose is that people who are deficient in the enzyme to convert methemoglobin to hemoglobin are at risk. They also say that infants lack this enzyme and pregnant mothers have this enzyme in reduced amounts.

          Quoting directly from them…

          “Healthy adults can consume fairly large amounts of nitrate with few known health effects. In fact, most of the nitrate we consume is from our diets, particularly from raw or cooked vegetables. This nitrate is readily absorbed and excreted in the urine.”

          Which is what is true and what we know, they go on to make a claim to this fallacy though

          “However, prolonged intake of high levels of nitrate are linked to gastric problems due to the formations of nitrosamines.”

          Nitrosamines do not form in the presence of antioxidants and phytonutrients such as vitamin C (unless animal fat is present). Dr. Greger’s future videos will go into great detail on this fact. The whole issue was with gastric problems from the original “livestrong” link so effectively, this is not a real threat to our health and we need not worry.

  • I have always loved beets. even as a kid I would eat all the veggies that everyone around me didn’t like. Now I juice beets and other vegetables and feel the difference immediately coursing through my body. Thanks for the research on one of my favorite roots.

  • vegantruth

    Could anyone comment on how the beet juice in the studies was prepared? A recipe or directions?

  • BPCveg

    Dr. Greger,

    I wasn’t sure of the best place to ask this question, but I’m placing it here because it relates to athletic performance.

    Is it fact or fiction that muscle-building athletes require substantially more protein than the average person (in body building handbooks recommendations are given such as 1 gram protein per pound of body weight per day, which are much higher than the RDA of 0.8 grams per kilogram of body weight per day)? If you can also reference any recent literature, that would be fantastic.

    Thank you.

    • Toxins

      When we need more protein, that typically means we need more calories. I am a competitive rock climber and I notice that after an intense climbing session, I am quite hungry. If im sore the next day I tend to get hungry faster than an average day, meaning im ingesting more protein. Calorie intake and protein needs go hand in hand on a whole food plant based diet. This is not a very scientific response but just from experience I know I get more then enough protein because I need to eat more food to maintain my condition.

      • BPCveg

        Thanks, Toxins, for your response. You make a good point about higher calorie intakes translating into greater intakes of protein, though it also seems possible that athletes like yourself are simply eating more to compensate for your energy loses. It is conceivable that the greater amounts of protein you consume are flushed out of your body without being incorporated into your muscle. Then it wouldn’t matter whether you ate more foods like beans or just took in calories from high carb foods like bananas.

        My aim is to figure out whether there is any point to the body building principle that one should consume a higher proportion of protein-dense foods to get faster muscle growth and a higher rate of performance. I am familiar with past studies that traced nitrogen, the so-called nitrogen balance studies, to measure protein utilization…I believe the RDAs for protein are based on this type of experiment, despite its crudeness and sources of error…therefore, I am curious to know the latest science on this subject.

        • Toxins

          Here is fitness expert Lani from Dr. McDougall’s forum answering a similar question u pose. Here is her response:

          When we’re working out, we need more calories than when sedentary. This means our food intake may well increase because we need more calories that will come in the form of carbohydrate, protein, and fat.

          This is different from isolating and upping protein out of balance with the other macronutrients, which is what I think you are referring to. Protein supplements have been pushed by the fitness industry based largely on, one, the profitability of the food supplement industry, and two, on the muscle-mongering, if that term makes sense, of the fitness industry. It is often a matter of one trainer repeating what another trainer said and so on.

          My friend Brad Pilon, who worked in the supplement industry for years pushing protein powders, eventually left the position when he discovered that the protein he’d been pushing wasn’t doing what it promised. He then wrote a book called How Much Protein where he examines the topic.

          Here are some of his words:


          Does More Protein Equal More Muscle?

          If you eat more, you‘ll gain weight, so if you eat more protein, you‘ll gain muscle. This theory seems correct on the surface. If we eat more calories, our fat mass expands – so if we eat more protein, our muscles should get bigger, right?

          What’s described above – the relationship between calorie surplus and body weight – is a basic dose-response relationship. If our bodies ingest extra calories, we continuously gain weight until our bodies can no longer support the weight.

          Body fat, or adipose tissue, is a storage house. Its function is to store excess energy. Fat can expand with an almost unlimited ability. Some morbidly obese individuals’ fat mass makes up more than 60 percent of their total body weight!

          So should we also assume that the same dose-response relationship exists when it comes to protein and our muscle mass? Unfortunately, no. Healthy humans can’t gain ever-increasing amounts of muscle mass by eating increased amounts of protein.

          Muscles don’t store protein in the same way that fat stores energy. They don’t expand to hold more proteins when we eat more proteins. In fact, only 20 percent of your muscle weight comes from protein – and only 50 percent of that amount is comprised of actual structural contractile proteins. (The rest is comprised of cellular proteins, such as enzymes, and fluid.) Most of the weight of your skeletal muscles is not from protein!

          If a dose-response relationship actually did exist between dietary protein and organs that contain protein in our bodies, then a high protein diet would not only cause our muscles to grow, but it would also cause our heart and most of our other organs to grow with unlimited potential.

          Don’t be fooled into thinking that your muscles will expand and contract as a result of your calorie or protein intake. Fat tissue will react in that way when it receives extra calories, but muscles will not.

          I am interested in health and fitness, and I have good reason to believe that overdosing on protein, regardless of what may be said about upping intake and working out to build muscle (which can raise IGF factors) is not a healthy practice.

          Getting too much protein is the concern ;-) .


          If your still dissatisfied with this answer I would click the link above and chime in on the conversation. Lani is very helpful.

  • Michael Greger M.D.
  • HuckinVonStompinCliffs

    Any reason why I shouldn’t start drinking 2 cups of beet juice a day immediately in order to win mountain bike races? I’m certainly looking forward to brilliantly colored bowel movements…..

    • NickyC

      Hey Huckin,

      Reducing your oxygen needs, which as this video shows is a byproduct of drinking beet juice, will most definitely have a positive effect on your mountain biking performance. Also, often a source of amusement when consuming beets, you touch upon an interesting point re: the colorful BMs that will most like result. As this other video demonstrates, this bright colored BM is a good thing…

  • Michael Greger M.D.

    For some context, please check out my associated blog post Using Greens to Improve Athletic Performance!

  • Steve Pastor

    I have read research that shows that “whole food juices” made with a Vita-Mix, by blending whole produce and water or ice, is not only much cheaper, but also far more nutritious than juice from a juicer. (I would of course include greens for the vitamin C to minimize any risk from nitric oxide production.)  Do you think the Vita-Mix version would give me the same increase in my ability to extract energy from oxygen, or should I buy a juicer for this purpose?  

    • I would stick with the VitaMix over the juicer. I don’t think you will adversely effect your bodies ability to absorb nitrates plus you will get the benefits of fiber which are many ranging from decreasing cholesterol see to increasing the speed that material goes through your gut see to avoiding cancer see the post at Good luck.

    • Richard Hachem

      Yes, it should be better with Vitamix or even shewing the whole food. But in this case, you would have to juice the beets because drinking about 10 beets (about what it takes for 500ml) with their fiber is pretty hard! I have a hard time drinking two beets from the Vitamix. It’s about 1% improvement, not huge, but can be really worth it.

      • Allan Mcfie

        I would say it’s exactly 1.7462 % improvement,with the VAT…….

  • Hi ! how many intakes per day (cups/ml) ? for how many days before ? should I had to drink to improve my MTB performance ? its save drink every day and week or just for a planned competition ? thanks Dr.

    • Richard Hachem

      You need to take 500ml per day (30% more if bio beet juice) for 6 days before race. It will give you about 1% more performance. I think it should be safe everyday, but you know what they say about too much of a good thing. I only do it before competition.

  • John Weissman

    It’s the sugar! needs a “control” with carrot or other sweet juice.

    • Richard Hachem

      No it’s not sugar and many studies on beetroot juice are double blind placebo controlled. So they do have control.

  • Kman

    Here you go doc:

    Before taking a long bike ride on a hot summer day, have some watermelon: The juicy fruit may ward off muscle pains. Researchers report that people whodrank watermelon juice before exercising felt less sore the next day than those who drank a pink placebo beverage (J. Agric. Food Chem. 2013, DOI:10.1021/jf400964r). They also found that cells absorb the presumed active ingredient, L-citrulline, more readily from unpasteurized watermelon juice than from plain water spiked with the compound, suggesting the natural source is the optimal delivery medium.

  • Derek Wolf

    Great video!

    You (and your readers) may also be interested to know that vitamin E carries similar performance-enhancing benefit. As with the beet juice, vitamin E will increase the efficiency of cellular respiration. Essentially it allows muscles to do more with less oxygen.

    There are many foods naturally rich in vitamin E – additionally there are quality supplement forms available to. I make a home-made “pre workout” formula from the liquid vitamins and herbs in my cabinet. Vitamin E is one of the key ingredients!

  • lovestobevegan

    Split the Difference Beet Stew

    -2 cups yellow split peas
    -6 cups water/homemade vegetable broth
    -3 medium beets, small cubes
    -2-3 stalks celery, thinly sliced
    -1 red onion, chopped
    -6 cloves garlic, minced
    -black pepper

    Mince garlic and set aside. Add all remaining ingredients to a large soup
    pot. Bring water to boil, then simmer, covered, over medium heat until peas are desired consistency and beets tender. Season to taste with black pepper.

    ~complements of plant-based emporium

  • lady research

    beet juice should not be taken in amounts larger that 1/4 cup per day

    • Gary Wofsey

      When Dr. Greger said “2 cups per day for 5 days,” did he mean 2 tablespoons?
      2 cups seems like an awful lot of beet juice, considering how potent it tastes.

  • joe

    THe problem with the study of 8 males is the sample size. It’s too small to give a credible margin of error or confidence level. In addition there was no control group mentioned. Smells like snake oil here.

  • Darryl

    A cautionary note I encountered (1, 2, 3), while delving into the BMAA story.

  • I am whole food plant based advocate and I have over the last few years also become an avid cyclist. I am currently training for 200 mile one day races this summer and 400 mile races this Fall. My question has to do with fueling my body through these races. I am wondering if I can fuel my body through smoothies over the period of the race and what would be the best indgredients to include in these smoothies? I need to replace 200 calories per hour on average.

  • marcus

    marcus can i put the hole beet in to my mixer. and what about the long steam’s and the leaf’s of the beet. and how many beet a day can i drink…

  • marcus

    and can they be raw – when i mix them up in the mixer to drink them. and what else can i mix with them. PS- like all my greens. or do i need to just do them by there self..

  • andries

    I am living in The Netherlands and I have just ordered your book How Not to Die also available now in our country, which I expect to receive next week and I thank you for your videos.