Hearts Shouldn’t Skip a Beet

Hearts Shouldn’t Skip a Beet
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The nitrate in vegetables, which the body can turn into the vasodilator nitric oxide, may help explain the role dark green leafy vegetables play in the prevention and treatment of hypertension (high blood pressure) and heart disease.

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Those of you paying close attention to this discussion of how beets can boost athletic performance may have noticed a term that sounded familiar—nitric oxide, which I talked about before in The Power of NO. It’s a vasodilator; helps open up blood flow. That’s how those nitroglycerine pills work when someone’s having angina. So if that’s how beets work, no wonder it lowers blood pressure as well.

Increasing athletic performance is nice and all, but if high-nitrate vegetables can do that, then these novel findings may have several clinical implications. A dietary therapy that lowers blood pressure and increases exercise tolerance may obviate the use of expensive drugs with potentially deleterious side effects. Look at this: drink some beet juice, and look what happens to your blood pressure within hours—and still working a day later!

We’ve known that fruits and vegetables reduce heart disease risk—particularly dark green leafy vegetables. We just haven’t exactly been sure why. These findings suggest that dietary nitrate underlies the beneficial effects of a vegetable-rich diet, and highlights the potential of a natural, low-cost approach for the treatment of cardiovascular disease. That’s why this prescription was published in an American Heart Association Journal.

Two cups of beet juice is a lot of nitrate, though. Although the magnitude of the improvement in performance after consumption of the natural vegetable juice beverage might seem surprising, it’s important to note that the acute dose of nitrate used in the present study (a half liter) is 4–12 times greater than the typical daily dietary nitrate intake in the United States. Yeah, but if it’s found in vegetables, how much is that really saying?

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by MaryAnn Allison.

Please consider volunteering to help out on the site.

Image thanks to Catherine Murray / 123rf

Those of you paying close attention to this discussion of how beets can boost athletic performance may have noticed a term that sounded familiar—nitric oxide, which I talked about before in The Power of NO. It’s a vasodilator; helps open up blood flow. That’s how those nitroglycerine pills work when someone’s having angina. So if that’s how beets work, no wonder it lowers blood pressure as well.

Increasing athletic performance is nice and all, but if high-nitrate vegetables can do that, then these novel findings may have several clinical implications. A dietary therapy that lowers blood pressure and increases exercise tolerance may obviate the use of expensive drugs with potentially deleterious side effects. Look at this: drink some beet juice, and look what happens to your blood pressure within hours—and still working a day later!

We’ve known that fruits and vegetables reduce heart disease risk—particularly dark green leafy vegetables. We just haven’t exactly been sure why. These findings suggest that dietary nitrate underlies the beneficial effects of a vegetable-rich diet, and highlights the potential of a natural, low-cost approach for the treatment of cardiovascular disease. That’s why this prescription was published in an American Heart Association Journal.

Two cups of beet juice is a lot of nitrate, though. Although the magnitude of the improvement in performance after consumption of the natural vegetable juice beverage might seem surprising, it’s important to note that the acute dose of nitrate used in the present study (a half liter) is 4–12 times greater than the typical daily dietary nitrate intake in the United States. Yeah, but if it’s found in vegetables, how much is that really saying?

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by MaryAnn Allison.

Please consider volunteering to help out on the site.

Image thanks to Catherine Murray / 123rf

Doctor's Note

Check out The Power of NO video I reference. And the athletic performance-enhancing effect of beets story begins with Doping With Beet Juice, is explained further in Priming the Proton Pump, and is confirmed in Out of the Lab Onto the Track. Also check out my other videos on blood pressure, my other videos on greens, and my other videos on heart disease.

For more context, also see my associated blog post: Using Greens to Improve Athletic Performance.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

27 responses to “Hearts Shouldn’t Skip a Beet

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      1. kabocha, you’re correct. The nitrites in processed MEATS are harmful. Dr. Greger delves into detail as to why this is so, i wont spoil it for you.

        Hint: animal fat plays a role in the transformation of nitrites to nitrosomines.




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    1. So they recognize their food is junk……… i don’t think they can fix it, once they do they’ll find another setback for tampering with years of evolution….. and so on.




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  1. Let me repeat here a question I put on another video but which may have escaped.
    I read in the book “The Nitric Oxide (No) Solution” that kale is the top source of nitrates, far better than beets. I wonder if with kale one gets the same effects as with beets, perhaps improved proportionally?




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  2. Thanks for your answer, after which I dug out the book and looked again at the table (page 64), which indeed gives not the nitrate content but the NO index. This is an index created by the two authors (Nathan S. Bryan and Janet Zand), which is calculated using two factors: the total amount of NO-creating nitrate and nitrite in the food, and the ORAC of that food. The figures reported in the book are as follows (for the top of the list):

    Kale 6825
    Swiss chard 2055
    Arugula 1452
    Spinach 1123
    Chicory 938
    Wild radish 914
    Bok choy 775
    Beet 632
    Chinese cabbage 499
    Beet (root) juice 482

    The book does not give references, it just quotes journals without giving the details. I do not know if this NO index is something trustable or just a proposal by two authors which did not get any following. Any opinion?




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    1. No biochemist I, but I observe that NO-generation and ORAC are two completely different things. NO is a free radical, while ORAC measures absorbance (destruction) of free radicals — antioxidant potency.




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  3. I got here via a search engine after Dr. Esselstyn’s advice to *chew* leafy greens six(!) times daily. The diagram in this video of the tortuous route from dietary nitrate to arterial NO is the only explanation I’ve encountered for the “chew” advice. I’m just curious as to its provenance.




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  4. Hi Dr Greger! I love your videos. Thanks for doing great work. I was so inspired by your videos on beets that I have been eating beets and juicing the leaves. The problem is that I have developed a rash or hives. What does this mean?




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    1. Actually, I do have a concern. I have normal blood pressure, but on the lower end, sometimes ALMOST too low, but always in the normal range. Would drinking beet juice before exercise drop my blood pressure too low, or would it simply help cardiovascular performance?




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    1. Matter of opinion – I love beets. Maybe try “pickled”. I find beet juice astringent and it feels like it hurts my throat. No way could I drink 2 cups of it. I was just wondering how much of the benefits apply to cooked beets.




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  5. These very same foods which are high nitrates are also high in oxalates. Such as swiss chard. I understand that cooking these vegetables reduces oxalate concentration by 80%. Just the same is not arugula the best choice because of its low oxalate concentration?




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  6. Dr. Greger
    Perhaps you are the one with the answer to my question that I have been grappling for some time. I noticed a correlation with beat juice and increased body aches. I still need to look into this a bit more to determine with certainty there is this correlation. However the question arises are nitrates/beet juice inflammatory? The mechanism is there to suggest that it is, but there are no reports of this being the case. In fact you make find statements on the net to the contrary. The mechanism which leads me to suspect that beet juice is inflammatory is the one that defines nitric oxide as an initial mediator to the inflammatory cascade. Your input and clarification would be highly appreciated. Thanks




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  7. Am late coming to the table on this but I take it the good doctor’s conclusion is that merely eating beets (or dark leafy greens) as opposed to ingesting them in copious amounts as juice is no guarantee of lowered blood pressure and boosted athletic performance?




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  8. Disappointed. I watched this video to learn how diet might help with cardiac arrhythmia, and there was no direct reference to this even though the title clearly refers to arrhythmias. Of course I found the video itself educational in general about the cardiovascular benefits of the plant based high nitrate diet which is indirectly useful.




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    1. Susie: My understanding is that beet greens are very healthy to eat and a wonderful part of a healthy diet, just like spinach. But also just like spinach, beet greens have a substance which binds up the calcium in them. So, even though the greens may seem like they provide a lot of calcium, your body doesn’t get much calcium from those particular greens. So, you will also want to make sure you include other greens in your diet for getting the calcium also.

      Brenda Davis has co-authored a guest post here on NutritionFacts and has done an interview which covers beet greens and more: http://www.choose-healthy-food.com/brenda-davis-interview-calcium-rich-foods.html




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  9. Too much of anything isn’t healthy, when talking about nitric oxide, how much beet juice would produce cell or DNA damage in the body?




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