The benefits and risks of beetroot juice consumption: a systematic review.

Critical reviews in food science and nutrition. 2021;61(5):788-804
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This review examined the health benefits and risks associated with beetroot juice (BRJ) from 86 studies. The nitrate contained in high amounts in BRJ increases nitric oxide (NO) levels in the body. NO has vasodilatory effects and thus reduces blood pressure and helps oxygen- and nutrient delivery to organs and muscles. Hence there has been an interest in BRJ for sports performance improvement and the prevention and treatment of cardiovascular disease. The review collected evidence of the effect of BRJ on the cardiovascular system and sports performance according to gender, trained and untrained individuals. Whilst the authors also briefly mention other health benefits of BRJ. From wider research, it is known that excess nitrate can form carcinogenic N-nitroso compounds (NOCs) in the body. Yet little is known whether this could also be a potential risk with BRJ consumption since vegetable consumption and many plant compounds generally appear to reduce the risk of cancers and can block the formation of NOCs. Hence the authors concluded that more research is needed to ensure that currently suggested dosages for BRJ do not aid NOCs production. In summary, BRJ has a beneficial effect on nitric oxide levels, oxygen consumption, blood flow, platelet aggregation, heart rate, cardiac output, blood pressure, improves sports performance and endurance and could be valuable for the management of cardiovascular disease. Yet high levels of consumption may not come without risks and more studies are needed to assess safety.

Abstract

Beetroot juice (BRJ) has become increasingly popular amongst athletes aiming to improve sport performances. BRJ contains high concentrations of nitrate, which can be converted into nitric oxide (NO) after consumption. NO has various functions in the human body, including a vasodilatory effect, which reduces blood pressure and increases oxygen- and nutrient delivery to various organs. These effects indicate that BRJ may have relevant applications in prevention and treatment of cardiovascular disease. Furthermore, the consumption of BRJ also has an impact on oxygen delivery to skeletal muscles, muscle efficiency, tolerance and endurance and may thus have a positive impact on sports performances. Aside from the beneficial aspects of BRJ consumption, there may also be potential health risks. Drinking BRJ may easily increase nitrate intake above the acceptable daily intake, which is known to stimulate the endogenous formation of N-nitroso compounds (NOC's), a class of compounds that is known to be carcinogenic and that may also induce several other adverse effects. Compared to studies on the beneficial effects, the amount of data and literature on the negative effects of BRJ is rather limited, and should be increased in order to perform a balanced risk assessment.

Lifestyle medicine

Fundamental Clinical Imbalances : Detoxification and biotransformational
Patient Centred Factors : Mediators/Beetroot juice
Environmental Inputs : Diet ; Nutrients
Personal Lifestyle Factors : Nutrition ; Exercise and movement
Functional Laboratory Testing : Not applicable
Bioactive Substances : Beetroot juice ; Nitric oxide

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article ; Systematic Review

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