Are There Health Benefits of Beetroot Juice for Athletes?

Written by Dr. Steve Chaney on . Posted in current health articles, Exercise, Food and Health

Should You Add Beetroot Juice To Your Training Diet?

Author: Dr. Stephen Chaney

 

health benefits of beetroot juiceWhen I saw the headline “Beetroot Juice May Boost Aerobic Fitness For Swimmers” I did a double take. Could something as simple as eating more beets actually improve exercise performance? Are there real health benefits of beetroot juice for athletes?  So I looked up recent papers on the topic.  But, before I review those I should give you a little science behind the idea that beetroot juice might affect performance.

The Science Behind Beetroot Juice And Exercise

Nitric oxide is a colorless, odorless gas that serves as an important signaling molecule in the human body. Among its many beneficial effects is increased blood flow to muscle. This increased blood flow appears to be preferentially distributed to the type 2 muscle fibers which support moderate to high intensity exercise. Thus, nutrients that enhance nitric oxide levels might be expected to improve moderate to high intensity exercise.

There are two naturally occurring pathways for producing nitric oxide in the body. The first pathway utilizes arginine, an amino acid found in dietary protein. The second pathway utilizes nitrates, which are found in fruits and vegetables. The best dietary sources of nitrates are beetroot, spinach and other leafy green vegetables.

Arginine has been widely used in sports supplements for some time to enhance performance. However, clinical studies on arginine have been mixed, with some showing small enhancements in performance and others showing no significant effect. Most experts now think that the benefits of arginine are primarily seen with untrained or moderately trained athletes (people like you and me) – not for highly trained or elite athletes.

It is logical that natural sources of nitrates, such as beetroot juice, would have a similar beneficial effect on exercise, but it is only in the last couple of years that scientists have started to evaluate that possibility. I looked up six recent publications for this review.

Does Beetroot Juice Improve Exercise Performance?

Study # 1: In this study (Bailey et al, J. Appl. Physiol., 107: 1144-1155, 2009) untrained men (aged 19-38) were given beetroot juice or a placebo for 6 days and then put through a series moderate-intensity and severe-intensity step exercise tests on days 4-6. The amount of oxygen required to support the moderate intensity exercise was decreased by 19% in the beetroot juice group. For severe intensity exercise, the amount of oxygen needed to support the exercise was decreased by 23% and the time to exhaustion was increased by 16% in the beetroot juice group. Those effects were statistically significant.

Study # 2: In this study (Kelly et al, Am. J. Physiol. Regul. Integr. Comp. Physiol., 304: R73-83, 2013) untrained older adults (aged 60-70) were given beetroot juice or a placebo for 3 days and then put through a treadmill exercise test. Resting blood pressure and oxygen uptake kinetics during exercise were significantly improved in the beetroot group.

Study # 3: In this study (Breese et al, Am. J. Physiol. Regul. Integr. Comp. Physiol., 305: R1441-14505, 2013) physically active subjects were given beetroot juice or a placebo for 6 days and then put through a double step exercise protocol involving a transition from stationary to moderate intensity exercise followed immediately by a transition from moderate intensity to severe intensity exercise. No significant differences were observed between the beetroot juice group and the placebo group during the transition from stationary to moderate intensity exercise. However, for the transition from moderate intensity to high intensity exercise both efficiency of oxygen utilization and endurance were increased by 22% in the beetroot juice group.

does beetroot juice improve exercise performance

Study # 4: In this study (Pinna et al, Nutrients, 6: 605-615, 2014) moderately trained male master swimmers were given beetroot juice for 6 days. Swimming tests were conducted at the beginning and end of the 6 day period. After 6 days of beetroot juice supplementation, the workload was increased by 6% and the energy cost was decreased by 12% when the swimmers were performing at their maximal capacity.

Studies # 5 & 6: These studies (Lanceley et al, British Journal of Sports Medicine, 47: doi: 10.1136/bjsports-2013-093073.8; Hoon et al, Int. J. Sports Physiol. Perform., 9: 615-620, 2014) were both done with highly trained athletes and no significant improvement in performance was observed. This is fully consistent with previous studies utilizing arginine supplements.

In short, these studies suggest that beetroot juice is similar to arginine supplements in that:

  • It improves exercise performance at moderate to severe exercise levels, but not at low exercise levels.
  • It improves exercise performance for untrained or moderately trained athletes, but not for highly trained athletes.
  • The effects are modest. However, you should keep in mind that even a 20% increase in endurance during high intensity exercise can result in a significant incremental increase in muscle mass if the exercise is repeated on a regular basis.

What Are The Strengths & Weaknesses Of These Studies?

Strengths: The strengths of these studies are:

  • Most of the studies were double-blind, placebo controlled studies
  • The studies were internally consistent and were consistent with previous studies done with arginine supplements.

Weaknesses: The weaknesses of these studies are:

  • The studies were all very small and were of short duration. Larger, longer term studies are needed to validate the results of these studies.

So, are there health benefits of beetroot juice for athletes?

The Bottom Line:

  1. Nitrates and arginine are both converted to nitric oxide in the body, so it is plausible that they will have similar effects.
  1. Arginine supplements have been around for years and appear to have a modest affect on exercise performance with untrained and moderately trained athletes, but not with highly trained athletes. This is most likely because one of the effects of training is to increase blood supply to the muscles. Thus, highly trained athletes already have enhanced blood flow to the muscles, and the effect of arginine supplementation on blood flow is less noticeable.
  1. Nitrate supplements are just starting to be evaluated for their effects on exercise performance. Most of the research so far has been with beetroot juice, but the results should be similar for any naturally sourced nitrate supplement.
  1. The clinical studies published so far suggest that nitrate supplements are similar to arginine supplements in that they have a modest effect on high intensity exercise in untrained and moderate trained athletes (people like most of us). They appear to have little or no effect for highly trained athletes. Thus, the effect of nitrate supplements on exercise appears to be very similar to the effect of arginine supplements on exercise.
  1. Most of the studies performed to date have been small, short duration studies. They need to be validated by larger, longer term studies.
  1. If the effects of nitrate supplementation published to date are accurate they should be most beneficial for weight training and high intensity exercise because even modest increases in exercise endurance can result in an incremental increase in muscle mass and strength over time.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Should You Avoid Sugar Completely?

Posted October 24, 2017 by Dr. Steve Chaney

Is It The Sugar, Or Is It The Food?

Author: Dr. Stephen Chaney

 

Should we avoid sugar completely?  Almost every expert agrees that Americans should cut down on the amount of sugar we are consuming. However, for some people this has become a “sugar phobia”. They have sworn that “sugar shall never touch their lips”. Not only do they avoid sugar sweetened sodas and junk food, but they also have become avid label readers. They scour the label of every food they see and reject foods they find any form of sugar listed as an ingredient. Is this degree of sugar avoidance justified?

 

Should We Avoid Sugar to Keep it From Killing Us?

 

Let me add some perspective:

  • If you just take studies about the dangers of sugar at face value, sugar does, indeed, look dangerous. Excess sugar consumption is associated with increased risk of obesity, diabetes, and heart disease. However, when you look a little closer, you find that most of these studies have been done by looking at the correlation of each of these conditions with sugar sweetened beverage consumption (sodas and fruit juices).

A few studies have looked at the correlation of obesity and disease with total “added sugar” consumption. However, 71.6% of added sugar in the American diet comes from sugar sweetened beverages and junk food. None of the studies have looked at the sugar from healthy foods like fruits, vegetables, and whole grains. That’s because there is ample evidence that these foods decrease the risk of obesity, diabetes, and heart disease.

  • For example, if apples had a nutrition label, it would list 16 grams of sugar in a medium 80 calorie apple, which corresponds to about 80% of the calories in that apple. The sugar in an apple is about the same proportion of fructose and glucose found in high fructose corn syrup. Apples are not unique. The nutrition label would read about the same on most other fruits. Does that mean you should avoid sugar from all fruits? I think not.

Avoid Sugar or Avoid Certain Foods

 

avoid sugar from junk foodsThe obvious question is: “Why are the same sugars, in about the same amounts, unhealthy in sodas and healthy in fruits?” Let’s go back to those studies I just mentioned—the ones that are often used to vilify sugars. They are all association studies, the association of sugar intake with obesity and various diseases.

The weakness of association studies is the association could be with something else that is tightly correlated with the variable (sugar intake) that you are measuring. Could it be the food that is the problem, not the sugar?

If we look at healthy foods (fruits, vegetables, whole grains) they are chock full of vitamins, minerals, phytonutrients, fiber, and (sometimes) protein. Fiber and protein slow the absorption of sugar into the bloodstream. As a result, blood sugar levels rise slowly and are sustained at relatively low levels for a substantial period of time.

In sodas there is nothing to slow the absorption of blood sugar. You get rapid rise in blood sugar followed by an equally rapid fall. The same is true of junk foods consisting primarily of sugar, refined flour and/or fat.  Avoid sugar from those types of foods.

Another consideration is something called caloric density. Here is a simple analogy. I used to explain the concept of caloric density to medical students in my teaching days. There are about the same number of calories in a 2-ounce candy bar and a pound of apples (around 278 in the 2-ounce candy bar and 237 in a pound of apples). You can eat a 2-ounce candy bar and still be hungry. If you eat a pound of apples you are done for a while. In this example, the 2-ounce candy bar had a high caloric density (a lot of calories in a small package). Perhaps a more familiar terminology would be the candy bar was just empty calories.

Are Sodas and Junk Foods Killing Us?

avoid sugar from candyPutting all that together, you can start to understand why the foods the sugars are in are more important than the sugars themselves. When you consume sugars in the form of sugar sweetened beverages or sugary junk foods, your appetite increases. We don’t know for sure whether it is the intense sweetness of those foods, the rapid increase and fall in blood sugar, or the high caloric density (lots of calories ina small package) that makes us hungrier. It doesn’t matter. We crave more food, and it isn’t usually fruits, vegetables, and complex carbohydrates we crave. It’s more junk. That sets in motion a predictable sequence of events.

  • We overeat. Those excess calories are stored as fat and we become obese. [Note: The low carb enthusiasts will tell you our fat stores come from carbohydrates alone. That is incorrect. All excess calories, whether from protein, fat, or carbohydrate, are stored as fat.]
  • It’s not just the fat you can see (belly fat) that is the problem. Some of that fat builds up in our liver and muscles. This sets up an unfortunate sequence of metabolic events.
  • The fat stores release inflammatory cytokines into our bloodstream. That causes inflammation. Inflammation increases the risk of many diseases including heart disease and cancer.
  • The fat stores also cause our cells to become resistant to insulin. That reduces the ability of our cells to take up glucose, which leads to hyperglycemia and type 2 diabetes. [Note: The low carb enthusiasts will tell you carbohydrates cause type 2 diabetes. That is also incorrect. It is our fat stores that cause insulin resistance and type 2 diabetes. Our fat stores come from all excess calories, not just excess calories from carbohydrates.]
  • Insulin resistance also causes the liver to overproduce cholesterol and triglycerides and pump them into the bloodstream. That increases the risk of heart disease.
  • Sugar sweetened beverages and sugary junk foods also displace healthier foods from our diet. That leads to potential nutrient shortfalls that can increase our risk of many diseases.

However, none of this has to happen. The one thing that every successful diet has in common is the elimination of sodas, junk foods, fast foods and convenience foods. You should avoid sugar from those foods as much as possible. Once you eliminate those from your diet,you significantly enhance your chances of being at a healthy weight and being healthy long term.

 

What About Protein Supplements And Similar Foods?

Of course, the dilemma is what you, as an intrepid label reader, should do about protein supplements, meal replacement bars, or snack bars. They are supposed to be healthy, but the label lists one or more sugars. Even worse, the sugar content is higher than your favorite health guru recommends.  So, should you avoid sugar from supplements and the like?

In this case, a more useful concept is glycemic index, which is a measure of the effect of the food on your blood sugar levels. Healthy foods like apples may have a high sugar content, but they havea low glycemic index.

avoid sugar and consume protein to slow absorbptionThe same is true for the protein supplements and bars you are considering. Rather than looking at the sugar content, you should be looking for the term “low glycemic” on the label. That means there is enough fiber and protein in the food to slow the absorption of sugar into the bloodstream and stabilize your blood sugar levels.

What Does This Mean For You?

Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should work on ways to avoid sugar or reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners. I have warned about the dangers of artificial sweeteners previously.

We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. For example, some Starbucks drinks are mostly sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

So we don’t have to avoid sugar completely, but we should reduce sugar from sugar sweetened beverages and junk food.

 

The Bottom Line

 

We need to keep warnings about the dangers of sugar in perspective:

  • The studies showing that sugar consumption leads to obesity, diabetes, and heart disease have all been done with sodas and junk foods.
  • Many fruits have just as much sugar as a soda. They also contain about the same proportion of fructose and glucose as high fructose corn syrup. Yet we know fruits are good for us.
  • Diets rich in fruits, vegetables and whole grains decrease our risk of obesity, diabetes, and heart disease.
  • That is because the sugar in whole foods is generally present along with fiber and protein, which slows the absorption of sugar and prevents the blood sugar spikes we get with sodas and junk foods.
  • In the case of prepared foods like protein supplements, you should look for “low glycemic” on the label rather than sugar content. Low glycemic means that there is enough fiber and protein in the product to slow the absorption of sugar and prevent blood sugar spikes.
  • Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should all work on ways to avoid sugar from junk foods or to reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners.
  • We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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