Like other root vegetables, beets sometimes become maligned for their carbohydrate content. Low carb zealots will chuck beets and yams into the same camp as white bread and licorice whips. This is utter nonsense.

Looking simply at total carbohydrate or even Glycemic Index misses the nuance of our foods. Just as you would be insulted if someone took a single aspect of your personality and used it to completely define you, so too do I imagine these vegetables slighted when they get blanketly demonized.

While Glycemic index was an initially helpful tool to assess the impact of carbohydrates, it was far too simplistic to be realistically applicable. More applicable is the glycemic load, which takes into account a true portion size. You can read more about key differences between glycemic index and load here (note the sample menu leaves a lot to be desired IMO).

While beets score a 65 on the glycemic index (which is medium-high) it would take about 4 cups of diced, cooked beets to impact your glucose levels in this fashion. A serving of cooked beets, which is 1/2 cup, has a glycemic load of 6 (low). Per serving, beets don’t contain a lot of sugar (6 grams, to be precise), and the fiber helps mitigate the rise in blood sugar that would occur if you consumed the same amount in pure cane sugar.

Additionally, beets contain Alpha-lipoic acid and induce nitric oxide, both of which appear to have a positive impact on blood sugar regulation.

Cell and animal studies show that alpha-lipoic acid (ALA) can increase the ability for glucose to get into the cell, alleviating the negative impact of insulin resistance in diabetic animals (4). A meta-analysis indicates ALA supplementation can reduce fasting glucose and insulin levels (2). It’s important to note, however, that many supplements contain far more ALA than one would get from eating beets. I was unable to find a source indicating how much ALA one can expect to consume in a normal dose of beets.

However, nitric oxide, which beet supports, has also demonstrated benefit in insulin resistance (3). One study showed that consuming beet juice with glucose reduced the severity of blood sugar response compared to glucose alone (1). It was postulated that the increase in nitric oxide availability from nitrate-rich beet juice may play a role in increased insulin sensitivity, at least in the obese individuals studied.  

Given that beets contain a low glycemic load, induce nitric oxide synthesis and contain some alpha-lipoic acid, there is no reason to fear consuming them. If you have diabetes, you can always test your individual reaction to beets by using your glucometer after a beet-rich meal to see precisely how your body responds to beets.

1) Beals, J. W., Binns, S. E., Davis, J. L., Giordano, G. R., Klochak, A. L., Paris, H. L., … & Bell, C. (2017). Concurrent beet juice and carbohydrate ingestion: influence on glucose tolerance in obese and nonobese adults. Journal of nutrition and metabolism, 2017.

2) Akbari, M., Ostadmohammadi, V., Lankarani, K. B., Tabrizi, R., Kolahdooz, F., Khatibi, S. R., & Asemi, Z. (2018). The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials. Metabolism, 87, 56-69.

3) Sansbury, B. E., & Hill, B. G. (2014). Regulation of obesity and insulin resistance by nitric oxide. Free radical biology and medicine, 73, 383-399.

4) Rochette, L., Ghibu, S., Muresan, A., & Vergely, C. (2015). Alpha-lipoic acid: molecular mechanisms and therapeutic potential in diabetes. Canadian Journal of Physiology and Pharmacology, 93(12), 1021–1027. doi:10.1139/cjpp-2014-0353

Beet juice supplementation has been all the rage in the running community the last few years. It’s easy to see why – it’s totally natural, healthy, and when you down a shot of beet juice it has quite a punch! It makes you feel like you’ve really done something significant.

Now, I’m a fan of beets. Not only are they adorable, but they are rich in antioxidants, folate, manganese and fiber. Research is strongly in favor of beets as an ally in prevention of high blood pressure and heart disease and is being investigated as a possible protector against dementia as well.

Beet juice contains nitrates (not to be confused with nitrites which are used to preserve meats). These nitrates can be used by the body to increase nitric oxide (NO), which dilates blood vessels (called vasodilation) and improves oxygen consumption. Beets are pretty darn awesome for many reasons, this being just one. That increase in vasodilation and NO production is why beets have a beneficial impact on hypertension, cardiovascular risk and athletic performance.

A study on male soccer players showed beet juice supplementation not only increased sprint speed but kept heart rate lower during exertion. With an increased ability to utilize oxygen, exercise becomes easier. While there’s no absolute in science, numerous studies seem to support the role of beet juice in sports performance among well-trained and recreational athletes.

It is, however, crucial to note that as of 2018 – only 2 studies on beet juice included women, and neither of these studies reported women’s hormonal status. A woman’s estrogen levels significantly impacts dilation and constriction of blood vessels and has significant impacts in day-to-day activity.  Endothelial-derived nitric oxide synthase, which controls BP response and promotes relaxation of blood vessels, is HEAVILY influenced by estrogen, so a woman’s hormonal status and whether or not she is on hormonal birth control is important to know.

1 study in early 2019 looked at endurance and resistance training on women taking oral birth control (OBC). The conclusion of this well-controlled study is that there was no performance effect despite vasodilation response. Supplementing with beet juice nitrates had no effect on time trials, aerobic capacity, or power output for women.

The supplement industry makes its recommendations based upon research that has been done on men. Men have more blood volume, hemoglobin, and lean mass than women which also impacts vasodilation response and endothelial response to beet juice, hormone differences aside.

For these reasons, and the fact estrogen increases vasodilation and can lower blood pressure, we cannot use research on beet juice done on men and apply it to women.  What is observed in the field is that women who are supplementing with beet juice nitrates experience excess vasodilation and more orthostatic hypotension if supplementing with beet juice, whether they are on oral birth control or cycling naturally. This can lead to increased dizziness and fainting.

I caution all my active women about the beet juice craze and encourage them to be mindful of how they feel, especially when they hit the post-ovulation, high hormone phase of their cycle. If she is taking oral contraceptive pills, I advise against beet juice supplementation altogether. It’s just not worth the risk, given that preliminary research shows women can’t expect the same results as men do.

Have you tried beet juice? What’s your experience been?