Beet Your Best: How Beets can Boost Athletic Performance & Lower Blood Pressure

Beta vulgaris

Ancient Use

Ancient Romans and Greeks used beets for various medicinal purposes, including treating circulation issues, fever, constipation, and even enhancing sexual performance. Beets were also cited as a remedy for “garlic breath.” (1) Given the wide range of purported benefits, a modern scientist might be tempted to dismiss these claims as mere placebo effects or the exaggerations of ancient medicine. However, a closer examination of the major phytochemicals in beets, along with modern scientific studies, reveals compelling evidence that beets can not only help lower blood pressure but also enhance athletic performance.

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Relevant Biochemical Pathway

To understand how beets influence blood pressure and athletic performance, we must first explore the role of nitric oxide in blood vessels. Nitric oxide levels are commonly measured as the sum of nitrate (NO₃⁻) and nitrite (NO₂⁻) in plasma. Nitric oxide diffuses into the smooth muscle lining of blood vessels, which relaxes the arterial walls. This widens blood vessels and allows blood to flow more easily (2). As a result, blood pressure decreases, and oxygen delivery to muscles improves—both critical factors for cardiovascular health and athletic endurance.

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Major Phytochemicals

Betalains, Polyphenols, and Nitrates

Beets are widely recognized for their vibrant colors, which result from betalains—water-soluble pigments with powerful antioxidant properties. Betalains have been shown to protect cells from nitrosative and oxidative stress. (3,4,5) In both plants and humans, chemical reactions can produce free radicals that contribute to cellular damage and inflammation. Antioxidants, such as polyphenols, help neutralize these free radicals, making them essential for maintaining cellular health.

In plants, antioxidants protect against oxidative stress caused by environmental factors like sunlight exposure. In humans, betalains help neutralize free radicals and increase the availability of nitric oxide in the blood. The combination of betalains, polyphenols, and naturally occurring nitrates in beets leads to a notable increase in nitric oxide within blood vessels after beetroot consumption.

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Nitric Oxide and Blood Pressure

Substantial evidence suggests that nitric oxide plays a critical role in regulating blood pressure. Patients with hypertension (high blood pressure) have been shown to have reduced nitric oxide levels in their blood (6). Additionally, hypertensive individuals often experience impaired vasodilation, meaning their blood vessels struggle to relax properly due to endothelial dysfunction (7). Beetroot juice has been shown to reliably increase blood nitric oxide levels in adults, as demonstrated by increased urinary nitric oxide excretion following consumption (8).

Studies on Beetroot and Blood Pressure

• A study in overweight individuals showed that drinking beetroot juice daily reduced systolic blood pressure by 7.3 ± 5.9 mmHg after three weeks. However, this effect diminished within a week of stopping beetroot intake, indicating that consistent consumption is necessary for sustained benefits (9).

• A randomized, double-blind, placebo-controlled study of 70 adults found that dietary nitrate decreased systolic blood pressure by approximately 7 mmHg over four weeks (10).

• A single dose of beetroot juice was found to cause a 5 mmHg drop in systolic blood pressure, lasting up to 24 hours in healthy adults (11).

• A systematic review of 11 studies concluded that beetroot juice effectively reduces blood pressure and should be promoted as part of a heart-healthy lifestyle (12).

The biochemical and human studies strongly support the ability of beetroot extract to lower blood pressure through nitric oxide-induced vasodilation. With hypertension becoming increasingly common, daily beetroot consumption may be a safe, natural, and effective way to help modestly reduce blood pressure

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Beetroot and Cardiovascular Exercise

Beyond its cardiovascular benefits, can beetroot also enhance athletic performance? Many studies suggest it can.

• A double-blind study of male runners found that those who consumed betalain-rich beet concentrates improved their 5-kilometer race times (23.0 ± 4.2 vs. 23.6 ± 4.0 minutes) (13). Runners who took beetroot also had:

  • 3% lower heart rate

  • 15% lower perceived exertion

  • 14% lower blood lactate levels

• Nitrate supplementation similarly improved 10-kilometer running time trials over four weeks in recreationally trained runners (14).

• A single dose of beetroot juice improved performance in trained cyclists at moderate simulated altitudes while reducing oxygen consumption (15).

• A study in triathletes found that betalain-rich beetroot concentrate not only improved running time but also reduced creatine kinase levels, a marker of muscle damage (16).

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Beetroot and Strength Training

Beetroot supplementation isn't just beneficial for endurance athletes—it also enhances strength training performance.

• In a double-blind study of resistance-trained males (17), consuming beetroot juice two hours before bench-pressing resulted in:

  • Increased mean power output

  • Higher velocity

  • More total repetitions during a bench press workout

• Jiu-jitsu athletes who took a beetroot-based gel supplement (18) had:

  • Improved grip strength

  • Increased oxygen saturation in forearm muscles

• Beetroot supplementation also improved performance in CrossFit-style high-intensity interval training (19).

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How Beetroot Optimizes Muscle Function

The benefits of beetroot go beyond blood flow—nitric oxide directly enhances muscle function at a cellular level. Nitric oxide enhances a muscle’s efficiency by optimizing calcium handling, blood flow, time to fatigue, and mitochondrial function (21).

1. Direct Effects on Muscle Contraction:

   • Nitric oxide binds to striated muscle myosins—proteins that control muscle contraction—acting as a molecular “gear shift”(22).

   • Studies show that nitric oxide increases calcium concentration in fast-twitch muscles, improving force production (23).

2. Reduced Fatigue and Soreness:

   • Nitric oxide increases oxygen delivery to muscles and reduces lactate accumulation.

   • This delays fatigue, reduces muscle soreness, and enhances post-exercise recovery (24).

3. Increased Mitochondria Production:

   • Nitric oxide activates PGC-1α, a key gene involved in mitochondrial biogenesis (25).

   • More mitochondria mean higher ATP production, leading to greater endurance and energy availability.

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Current Medical Uses for Nitrates

As a hospitalist, I frequently use nitrate-based medications in patients with heart attacks. Nitroglycerin, for example, is a critical treatment that dilates coronary arteries, restoring blood flow to the heart (26).

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Potential Side Effects

Since beetroot increases nitric oxide, its side effects are similar to those of medical nitrates (27):

• Headaches (due to vasodilation that will be discussed in a future article on migraines)

• Dizziness or low blood pressure (especially if dehydrated)

To minimize side effects:
✔ Stay well-hydrated
✔ Avoid combining with other vasodilators/diuretics
✔ Adjust dosage if experiencing headaches or dizziness

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Fun Facts

• Beeturia: Beets contain betanin, which can turn urine or feces red or pink for up to 48 hours. This is harmless but more common in individuals with iron deficiency (28).

• Oral Bacteria and Nitrate Conversion:

  • Oral bacteria are essential for breaking down nitrate into bioactive nitrite.

  • Using antibacterial mouthwash can reduce nitrate conversion, lowering nitric oxide levels (29).

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Personal Use

In the past few years I have made it a priority to be more active and after learning about the phytochemicals in beetroots, I have used beetroot gummies for many different athletic activities:

• I notice less fatigue and faster run times when I take beetroot gummies before a 3-mile run.

• I carry beetroot gummies when hiking, and I particularly noted benefits after taking them when I was tired during two difficult hikes: while summiting Mt. Fuji and when hiking the 33-mile Milford Track in New Zealand.

• I take them before Taekwondo classes and I have observed improved stamina and endurance during drills and sparring.

For optimal athletic benefits, beetroot supplementation should be taken around 90 minutes before exercise, as nitrate levels peak 2–3 hours after ingestion. (30)

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My Beetroot Routine

• 2 beetroot gummies (300 mg of beetroot extract + 4 mg of black pepper extract total)

• 1 Vitamin C gummy (helps convert nitrite to nitric oxide)

• I usually take them 60–90 minutes before activity

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Recommendation

• If using beetroot gummies for the first time, start with a lower dose of 100-200 mg of beetroot extract. If you don’t experience any issues such as dizziness or headaches, you can gradually increase the dosage up to 600 mg over a few weeks.

• Only add Vitamin C after you have tolerated the beetroot gummies alone for at least 1-2 weeks.

• This gradual increase is a precaution to prevent sudden vasodilation, which may cause dizziness, flushing, chest discomfort, fainting, or shortness of breath if your body is not yet accustomed to it.

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Future Research

In a society where high blood pressure is becoming more rampant and can lead to heart failure or strokes if left untreated, we should examine all safe and efficacious options to lower blood pressure. If beetroot supplementation can replace or delay the addition of a blood pressure medication for someone with hypertension, then, in my professional opinion, this should be researched more extensively. Furthermore, it is well known that regular exercise is a key component in preventing obesity. If beetroot supplementation is able to increase exercise performance without major side effects, then this could be a useful tool in improving cardiovascular health and weight management. Beetroot’s historical, biochemical, and clinical evidence make it an exciting natural remedy for hypertension treatment and athletic performance enhancement worth further scientific exploration.

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References:

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