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Title : The Amazing Health Benefits of Beetroot
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The Amazing Health Benefits of Beetroot

id = " It is estimated that 22% of adults worldwide exhibit increased blood pressure (WHO 2014), and systemic hypertension remains the main risk factor for mortality attributable worldwide -. growing trend (Kapil et al 2015). On the positive side: Recent studies provide compelling evidence that ingestion of beet ( Beta vulgaris rubra , red beet) provides beneficial physiological effects can translate into improved clinical outcomes of diseases such as hypertension (high blood pressure), atherosclerosis, type 2 diabetes, and dementia. Beetroot has a positive effect on the cardiovascular system. As for hypertension, numerous studies showed beet significantly reduced systolic and diastolic pressure (Table 1) when delivered acutely as a juice or bread (Clifford et al. 2015).

What's in a beet?

In addition to the high levels of inorganic nitrate, NO 3 - , beet contains several potent phytochemical compounds: ascorbic acid (vitamin C), vitamin A , vitamin B6, flavonoids, carotenoids, phenolic acids and betalains, a group of violet-red or yellow-orange pigments with strong antioxidant and anti-inflammatory (Ninfali and Angelino 2013). This has aroused the interest to investigate the possible roles of beet in pathologies characterized by chronic inflammation and oxidative stress (see Box 2), such as liver disease, arthritis and cancer (Clifford et al. 2015). Other antioxidants identified from beet include Techin epica, rutin and caffeic acid. It also contains sugar, potassium, magnesium, folic acid, iron, zinc, calcium, phosphorus, sodium, niacin, biotin, and soluble fiber (Wootton and Ryan Barba 2011, Crocker 2008).

How does it work?

To understand how the beet exerts its positive effects, we will visit some relevant biochemistry for good vascular health (ie, happy blood vessels). Nitric oxide, NO, is an important messenger molecule that modulates a large number of physiological processes, ranging from vasodilation, muscle contractility, and immune function in neurotransmission and (Wylie et al. 2013, Weitzberg et memory al. 2010). The endothelium (inner layer of blood vessels) is used to signal the muscle tissue surrounding relax, leading to dilated blood vessels and increased blood flow. People who suffer from cardiovascular disease, including high blood pressure, usually have lower levels of NO (Kapil et al. 2015). Therefore, one would think that nothing delivery of NO in blood vessels can relieve symptoms. This is only partly successful, however. Use of NO from organic molecules, such as nitroglycerin showed benefits and complications (Kapil et al. 2015). But what of NO derived from inorganic sources (Table 3)? Since some vegetables (eg, beets, spinach, lettuce) contain high amounts of (inorganic) nitrate, researchers investigated the possibility that the beneficial effects established of a diet rich in vegetables cardiovascular diseasemay be partly due to nitrates (Weitzberg et al., 2010, Webb et al., 2008). In fact, the use of inorganic nitrate has a long medical history: August 1 ap manuscript of Chinese discovered century Buddhist grotto of Dunhuang advisable to administer the Nitro (KNO 3 ) via sublingual to relieve angina (butler & Feelisch 2008). Placement under the tongue was crucial to achieve pain relief (see why below). Potassium nitrate is used as a diuretic for edema from the 16th century and various nitrate salts were in use until the mid-1930s, when alternatives are available diuretics (Lidder and Webb 2012). The idea that inorganic nitrates have beneficial effects in patients with high blood pressure through conversion to nitrite ran over 80 years ago, and more recently also confirmed for healthy people (Coles et al. 2012, Kapil et al ., 2010, Webb et al., 2008). Therefore, we will see beets in particular. It contains high levels of bioavailable inorganic nitrate, NO 3 - (250 mg / kg fresh weight). The short version is that the intake of beet delivery nitrate NO derived from the blood vessels, causing dilation and reducing blood pressure by up to 10 units in a 24 hour period, with the greatest impact ~ 3 hours after drink the juice (Webb et al., 2008). In more detail, the body has two ways of providing NO: from endogenous reactions, and through the provision of food. After a meal rich in nitrate, the small intestine absorbs quickly, with nitrate levels in blood plasma greatly increasing and remains elevated for hours (Presley et al. 2011, Lundberg et al. 2008). Plasma nitrite (NO 2 - ) also increase levels after ingestion of nitrate, although slower (Webb et al., 2008). Although most nitrate is excreted in the urine, up to 25% make their way to the salivary glands with subsequent exposure to bacteria from the tongue in the oral cavity (Weitzberg et al. 2010). Remember that the Chinese manuscript advise people to put nitrate (KNO as 3 ) under your tongue? bacteria from the tongue reduce nitrates to nitrites - a crucial step because mammals can not metabolize efficiently NO 3 - , based on oral and gut bacteria symbiotic place (Lundberg et al., 2008). Swallowing saliva, nitrite enters the stomach and circulation, where the enzymes become NO, resulting in vasodilation and lowering blood pressure significantly (Kapil et al. 2015). Note that the regular use of antiseptic mouthwash can reduce bacteria language, and with them orally nitrate - conversion of nitrite (Clifford et al 2015). In fact, the use of mouthwashes has been correlated with increased blood pressure in rats and humans (Habermeyer et al. 2015). All in approximately 5% of a portion of nitrate to nitrite convert ingested (Bryan & Ivy 2015). This pathway reducing nitrate to nitrite and then NO has also been demonstrated in the stomach, on the surface of the skin and in urine (Lundberg et al. 2008). Furthermore, the presence of vitamin C and polyphenols (reducing compounds), as readily available fresh food, greatly enhances the reduction of nitrite to NO (Lundberg et al. 2008). beet beneficial effects on the cardiovascular system are attributed largely to its high content of nitrate. (Then nitrate are discussed. Since the positive effects of beet largely attributed to nitrate and can be the basis of the recognized benefits for the health of a vegetarian diet, I seemed an understanding of important nitrate. You can jump to read more about the use and benefits of beets, though ...)

But wait, I thought was harmful nitrate?

Generally, nitrate is the subject of ongoing scientific debate, no consensus over the past 50 years (Powlson et al., 2008). When reading the literature, it seems that there are two factions: one that advocates rethinking nitrate (in terms of recommended limits and real applications for health), and pointing out potential hazards (as evidenced mostly by animal studies ), which require more research before changing security levels (Grinsven et al. 2006).

Nitrate and Public Perception

The public perception of nitrate leans toward the negative rather than the positive. Butler & Feelisch (2008) give a good account of the reasons: "The driving force for appears to have been the fear encouraged by the discussions in both the popular press and scientific literature about the health risks exposure scenarios to nitrite and the nitrate development. the reports of methemoglobinemia [when nitrite reacts with hemoglobin, resulting in methemoglobin which cannot carry oxygen] in infants caused by drinks or foods prepared with rich nitrate (and contaminated with bacteria) well water and vegetables such as spinach, celery and carrots ( "syndrome blue baby "), intentional and occupational poisonings in adults, increasing nitrate levels in the soil and lakes as a result of excessive use of fertilizers, and the formation of N-nitrosamines, potentially carcinogenic products contributed to the negative image nitrite and nitrate have been made in recent years. as a result, there have been significant efforts to remove as much of nitrite and nitrate as possible of our drinking water, to advocate replacement of nitrite by others (often less effective ) food preservatives, and to establish culture conditions that lead to crops with low nitrate levels. Despite the possible long-term consequences of a reduction of chronic intake of nitrite and nitrate on human health they are unknown, questions have been raised about the risk to the overall health of the intake of nitrite / nitrate. […] Despite the critics, the image of nitrite and nitrate remains stigmatized. " Concern for nitrate is mainly due to cases of infant methemoglobinemia and a possible link to cancer of the digestive tract (Powlson 2008).

nitrate and cancer

Although neither nitrite nitrate or act as direct carcinogens, nitrite derived from nitrate in the diet may react with dietary amines to form carcinogenic nitrosamines. Since 1973, about 50 epidemiological studies investigating the relationship between nitrate and the incidence of stomach cancer failed to show a convincing link (Powlson et al 2008, Lidder and Webb 2012). Even some studies reported a cancer rate lowered associated with high intake of nitrate (Björne et al., . 2004), and, as we shall see, many researchers realize the beneficial effects of dietary nitrate the European Food Safety Authority summarizes: "epidemiological studies do not suggest that nitrate intake from diet or drinking water associated with an increased risk of cancer. Evidence that high intake of nitrite might beassociated with increased cancer risk is equivocal "(EFSA 2008). With the exception of specific nitrosamines snuff, evidence of carcinogenicity of N-nitroso compounds in humans is inconclusive , despite a review strongly 2012 concluded that there was no association between the formation of nitrosamines in humans and gastric cancer (Butler 2015). But prospective cohort studies suggest an association of red meat and meat consumption nitrite -preservada with an increased risk of colon cancer and chronic lung disease (Habermeyer et al. 2015, Hord et al., 2009). (sodium nitrite serves as coloring, flavor enhancer and antimicrobial agent in cured meats and processed including bacon, bologna, corned beef, hot dogs, cold cuts, sausages, canned and cured meat and hams.) The cohort study tracking 120,000 Dutch men and women 16.3 years and he concluded that, despite nitrosamines in the diet can cause esophageal carcinomas, there is a clear association with other gastric subtypes (Butler 2015). Overall, the evidence of a cancer causing role of nitrate and nitrite in humans is inconsistent (Milkowski et al., 2009).

nitrate and water

Drinking water contains varying amounts of nitrate, which is derived from nitrogen fixation and bacterial decomposition of organic compounds on the floor. The amount of nitrate in water allowed is regulated in Europe (50mg / l) and US (44 mg / l), from the 1940s, after noticing an apparent connection between infantmethemoglobinemia and well water containing high levels of nitrates. Consequently, the EPA (Environmental Protection Agency US) has set a maximum contaminant level for nitrate of 10 mg / l (nitric oxide (NO 3 -N), multiply by 4.42 to give over 44 mg / l, referring to NO 3 - ions), last revised in 2002 (EPA 2007). However, in 1948, experiments with babies (!) Showed levels of nitrate as a likely cause of infant methemoglobinemia, but rather that exposure to fecal bacteria (well water) and subsequent intestinal infections caused condition ( Powlson et al., 2008). In fact, methemoglobinemia is unlikely in the absence of contaminating bacteria, as these are required to convert the nitrate to nitrite to nitrite levels raised to affect a baby (Lidder and Webb 2012). said, the cumulative environmental load of nitrate fertilizer use and livestock production on a large scale (high nitrate manure) can cause significant changes in terrestrial and aquatic ecosystems, which may affect their biodiversity and abundance of species, with knock-on effects for humans (Powlson et al., 2008, Grinsven et al., 2006). Examples include nitrate runoff into rivers and lakes that cause excessive growth of algae and associated (decreased oxygen levels) in coastal waters and estuaries anoxia, and contamination of groundwater (Katan 2009). What about the concentration of nitrates in the diet?

Nitrate and Diet

The World Health Organization (WHO) first recommended a higher level for nitrate in the diet 1962: the ADI (acceptable daily intake) for nitrate is 0-3.7 mg / kg (WHO Food Additive Series 50). That still stands and is equivalent to 259 mg of nitrate for an adult of 70 kg (or ~ 4.2 mmol). The ADI is based on a brief FDA (Food and Drug Administration of the United States) rats test report and two dogs in sodium nitrate. WHO took these results and calculated a dose? Body weight 500 mg sodium nitrate / kg was harmless to rats and dogs (Katan, 2009). They dividing that result by 100, they reached the current ADI for human consumption nitrate or sodium nitrate given as 5 mg / kg, or 3.7 mg / kg NO 3 - (equivalent to 0.06 mmol NO 3 -. ) despite being an important source of nitrate, increased consumption of vegetables is widely recommended because of their beneficial effects on health generally accepted (EFSA 2008). Some even suggest the well-known effects, which promote the health of the Mediterranean diet could be partly due to nitrate (Butler & Feelisch 2008). A vegetarian diet contains ~ 4.3 mmol of nitrate per day, close to the IDA, but almost four times more than a "normal" diet ~ 1.2 mmol (Lidder and Webb 2012). A relatively wide range of dosage nitrate has been studied in humans and mice, showing a clear therapeutic benefit without any signs of toxicity (Bryan & Ivy 2015). In fact, acute ingestion of nitrate (eg beet juice), and may exceed the ADI (Lidder and Webb 2012, Lansley et al 2011), apparently without harmful consequences suggested (Butler 2015), but lot of beneficial:

• nitrate derived NO inhibits adhesion of blood platelets and aggregation (Lidder and Webb 2012)
• lowers blood pressure (Kapil et al. 2015)
• reduces the oxygen cost of exercise (Lansley et al. 2011),
• improves intestinal health (Björne et al., 2004),
• preserves or improves endothelial dysfunction (Webb et al., 2008),
• improves exercise performance in healthy individuals and in patients with peripheral arterial disease (Lidder and Webb 2012)
• It has anti-inflammatory properties (Ninfali and Angelino 2013)
• from 2001, nitrite provide an important alternative source of nitric oxide (NO), particularly in reducing oxygen levels was found (Liddder and Webb 2012),
• nitrite protects mitochondria drecreasing production of oxygen radicals (Weitzberg et al. 2010)
• nitrite accelerates wound healing through exert antibacterial effects (Butler & Feelisch 2008)
• nitrite can increase cerebral blood flow in hypoxic areas and maintain cognitive function ( Presley et al. 2011).

The body regulates its levels of nitrates, the excretion of excess when exposed to high loads of nitrates in the diet (Lidder and Webb 2012) -. You can find the colors of urine beet and feces (beeturia) (Presley et al 2011). Foods rich in nitrate (> 1 g / kg), in descending order: rocket, spinach, lettuce, radish , beets, bok choy; Plants with nitrate levels medium (<1g/kg): turnip, cabbage, green beans, leek, spring onion, cucumber, carrot, potato, garlic, peppers (Lidder & Webb 2012). Also interesting to note: not all plant parts contain equal amounts of nitrate. Generally, leaves exhibit higher amounts than stems > roots> fruits> content. nitrate plant seeds depends on the genotype, soil quality, use of fertilizers, storage conditions, among other factors (Hord et al., 2009).

So what to do with it?

Given the evidence, consuming increasing amounts of vegetables is associated with a reduced risk of cardiovascular disease and increasing longevity. a World Wide Fund for cancer Research to assess the impact of food, nutrition and physical activity on the incidence of cancer showed no link vegetable intake with increased cancer (Kapil et al. 2011). in fact, all evidence points to the contrary. Similarly, evidence linking ingestion of inorganic nitrate to a higher incidence of cancer is weak (Katan 2009). Butler & Feelisch (2008) also provide a good point regarding nitrite causing digestive tract cancers: "Interestingly, the average dietary intake of nitrate equals roughly the endogenously produced by NO production. Therefore, if nitrite were really of concern to human health because of its propensity to form carcinogenic nitrosamines, then the human body would have a significant evolutionary design flaw because c. 5% of all ingested nitrate produced endogenously finally ends as nitrite in the stomach. ". Weitzberg et al (2010) express their view on the nitrate in this way:" The nutritional consequences of nitrate and nitrite in biology are exciting. The amounts of these anions necessary for the effects on the cardiovascular system […] are easily achieved by our daily diet. Future studies will determine whether the cardiovascular benefits of a diet rich in vegetables, such as the Mediterranean diet, are associated with nitrate. If that is the case, we may have to reconsider our current thinking, and what is currently considered a harmful component in the future could be considered an essential nutrient. " Five years later, Bryan & Ivy (2015) agree with the view of nutrients, adding to the previous evidence that nitrate / nitrite have beneficial effects in exceeding the recommended limits (Hord et al., 2009) levels. And as said before, nitrate levels salivary can actually rise above many times the limit of the acceptable daily intake after ingestion of beet (Tamme et al., 2010, Lundberg et al., 2008) or consumption of high amounts of vegetables rich in another nitrate (Habermeyer et al. 2015, Gilchrist et al., 2010)., consumption of beet juice to the regular day long is well tolerated (Kapil et al. 2015) and evidence of carcinogenic effects of dietary nitrate / nitrite is inconsistent (Bryan & Ivy 2015, Gilchrist et al., 2010). If the patterns of typical consumption of vegetables and fruits exceed regulatory limits - beet juice or a serving of spinach consumed in a serving of salad can be above the ADI -. The value of that directive becomes questionable (Bryan & Ivy 2015, Hord and others, 2009). Given the long time required for new discoveries of basic science to take root and result in the well-established practice - 17 years - maybe it's time to reconsider nitrate, now. Although I am not to change (sensitization) Limits nitrate environmental / nitrite, I think innate intelligence of our body handles levels dietarynitrate / high nitrite, as the result of beet and other vegetable intake by itself ( see Webb et al., 2008 for images showing the ingestion of nitrate and its subsequent fate in the body). In fact, nitrate is involved in many physiological processes, which can not simply be discarded as an unwanted toxin (Carlstrom et al. 2010, Hord et al. 2009). On the contrary, the body requires to function properly correct amounts, nitrate reabsorption by the kidneys (an estimated 96%) and the production of its own. Paracelsus was probably right in saying: (Bryan & Ivy 2015) I add my regular beet vegetable juice every day, do not worry "The dose makes the poison.". Of course, under clinical considerations, the situation for a hypertensive person may be different. That said, Kapil et al. (2015) posit that the effects observed in patients with hypertension slight decrease in blood pressure may be higher in patients with more severe hypertension, shared by other sentiment: "This, therefore holds the promise of nitrate in the diet will be more effective in reducing blood pressure [BP] when it is needed, ie, in people with high blood pressure or normal pressure, and the results of nitrate in the diet of hypertensive expected. Similarly , nitrate in the diet seems to induce unwanted hypotension [low blood pressure] in people with low blood pressure normally. the circulation enterosalivary also provides a mechanism inherent limitation to avoid excessive conversion of nitrate to nitrite, avoiding the risk of toxicity nitrite "(Lidder and Webb 2012, Webb et al. 2008). The expected results are alluded is now available in Kapil et al. (2015), which provide the first clinical evidence "of reducing blood pressure lasting dietary supplementation nitrate [beetroot juice] in a group of patients relevant".

How Should I Ingest Beets? In what way?

The choice of the correct amounts can be tricky. The investigation revealed that polyphenols and antioxidant capacityof beet were higher in systems biodynamic farming and integrated compared with conventional agriculture (Ninfali and Angelino 2013) and an Austrian study showed that products beet by different manufacturers also vary widely in its nitrate content. Wruss et al. (2015) tested 16 commercial juice, four powders beet freshly prepared from seven different varieties beet juice. Nitrate content diverged by a factor of 10 between freshly pressed juice (approx range 0.56 -. 4.6 g / l) and a factor of between 240 and commercial juice powders (range from 0.01 to 2.4 g / l). With the exception of a variety of beet (Robuschka), fresh juices contained significantly higher levels of nitrate (an average of 1970 mg / l, corresponding to about 985 mg / kg fresh weight) as compared to commercial juices. This seems to speak for a juicer and start beet crop. =) At least to read labels and thus make better decisions. Apart from the volume used, matters actual concentration of nitrates to accurately determine consumption. It should be printed on the label or be available from the manufacturer. With the information given here must be equipped to determine the best volume of juice for a particular product (Table 4). Let's take a look at what volumes beet juice and various concentrations applied studies to measure the effects. Webb et al. (2008) used the organic beet juice to study the effect on blood pressure in healthy volunteers. Participants drank 500 ml of beet juice either (0.3 mmol nitrate / kg) or water with repeated blood pressure readings taken during the next 24 hours. After three hours of ingestion, a reduction in systolic blood pressure (10 mmHg) and diastolic blood pressure (8 mm Hg), with the effect it is still present 24 hours after a single administration was observed. Later, the same group used 250 ml (5.5 mmol) of nitrate organic beet juice in healthy volunteers, the observation of similar effects (Kapil et al. 2010). Wylie et al. (2013) tested supplementation with organic beet juice in healthy volunteers to observe similar results in 140 ml and 280 ml volumes (which equals ~ 8.4 and 16.8 mmol of nitrate content). Zamani et al. (2014) tested, obese hypertensive patients with heart failure (> 56 years) in stable medication to improve exercise capacity under the influence of a single administration organic beet juice (140 ml, 12.9 mmol nitrate) . Their data suggest that NO 3 -. improves exercise capacity in study participants by raising maximum oxygen consumption and delivering more oxygen to active muscles Another study supplementation beet juice in older adults provide two drinks a day (816 mg total nitrate) to observe an increase in plasma nitrite concentration, reduced blood pressure, and positive physiological responses to exercise. the nitrate supplementation at a dose of 6.62 mg / kg may also improve exercise performance in patients with peripheral arterial disease (Bryan & Ivy 2015). A UK company has developed a shot ml of organic beets 70-Barba Wootton and Ryan (2011) found that a potent liberator of antioxidants and polyphenols. Other companies also create shots beet and sports drinks high nitrate (eg, 240 mg / 60 ml serving) (see Wruss et al. 2015). blind, placebo-controlled clinical trial in hypertensive patients offer 250 ml (~ 6.4 mmol) of nitrate organic beet juice a day for four weeks double A recent study showed a sustained and significant reduction blood pressure (Kapil et al 2015). Endothelial function also improved by c. 20% and decreased arterial stiffness. Patients tolerated the intervention, with no signs of tachyphylaxis or endothelial dysfunction induced, unlike other interventions NO using organic nitrates (such as nitroglycerin) (Kapil et al. 2015, Lidder and Webb 2012). The researchers conclude: "This is the first evidence of reduced lasting blood pressure with dietary supplementation of nitrate in a group of relevant patients These findings suggest a role of dietary nitrate as an affordable, easy treatment to get,. adjunct in the treatment of hypertensive patients. " Out of all references, this would be one that take your health professional to discuss your options "beet". It presents interesting results. Bring to the attention of your doctor!

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