Beetroot and beet juice – in moderation

Have you seen publicity about beetroot juice? It’s good for all kinds of things, apparently. It improves failing memory, enhances stamina, reduces blood pressure and even acts as a kind of natural male potency enhancer.

Or does it?

Increased athletic performance

Beetroot and beet juice - in moderation NutriShield Multi Vitamins and MineralsThe story was originally kick-started in the mainstream media a few years ago by a trio of scientific papers, all from the University of Exeter, which showed that taking dietary nitrate in the form of beetroot juice increased athletic performance (1, 2, 3).  The performance improvement was significant: the juice boosted stamina and allowed people to exercise for up to 16 per cent longer.

This was not really new work at all, as the basics had already been proven by a team at the Karolinska Institute in Stockholm back in 2007 (4).

The stories were accurate enough, however. Drinking beetroot juice provides a large enough dose of nitrate to alter blood flow and oxygen metabolism in a way that genuinely does enhance physical performance, and many athletes are now bulk-buying this vegetable juice and using it as a form of natural doping!

An arterial relaxant

Beet juice may also have medical applications. Nitrate is metabolised in the body to nitric oxide (NO), a powerful messenger compound with multiple effects in the body including the relaxation of arteries. The changes in arterial behaviour which occur when nitrates are ingested would be expected to reduce the symptoms of intermittent claudication, a painful cramping of the calf muscles that is a consequence of peripheral vascular disease and often diabetes.

Nitrates would also be predicted to reduce blood pressure, which makes beetroot juice a potential treatment for hypertension. I am not aware of any studies yet on intermittent claudication, but at least two reports find that beetroot juice (5) and inorganic nitrate (6) do indeed lower blood pressure. These two studies were both in healthy volunteers but they certainly suggest that beetroot juice could be an alternative or adjunct to anti-hypertensive drugs.

There are no scientific reports of the use of beet juice as a sexual enhancer, but as its mechanism of action on blood flow is in some ways similar to that of Viagra, there has been a lot of speculation (fuelled, no doubt, by the companies that make beet juice), that this fashionable new drink could be a kind of sex aid.

Brain food?

To add to the media hysteria, a trial also demonstrated that beetroot juice increases blood flow in certain key areas of the brain (7).  A major feature of nitrate’s ability to increase blood flow is that it acts preferentially in conditions of low oxygen, allowing nitrate to increase blood flow precisely in the areas where it is needed most.

In this study, the high nitrate diet did not alter total cerebral blood flow, but did lead to increased regional blood flow in the frontal lobe white matter – the areas of the brain commonly associated with degeneration that leads to dementia and other cognitive problems. The scientists who did this study at North Carolina’s Wake Forest University claimed that this improvement in blood flow might improve mental function in the elderly.

Beetroot and beet juice - in moderation NutriShield Multi Vitamins and Minerals

Enjoy beetroot in Health Defence Cookbook recipe “Roasted vegetables with cracked wheat salad”

But danger of too much nitrate

So should we all be drinking daily beet juice for breakfast? I’m afraid that the answer is almost certainly NO. This is because in the longer term, too much nitrate is not good for us.

You’ll know that nitrates are often added to processed meats like bacon, ham, sausages and hot dogs, as they add a pink colour and function as preservatives to help prevent the growth of harmful bacteria. Unfortunately these processed meats are strongly linked to increased cancer risk of the digestive tract.

Moreover, despite the above research suggesting that nitrates could be used to help the ageing brain, there is a good deal of evidence that high dietary nitrate levels will increase the risk of developing Alzheimer’s.

High levels of dietary nitrate lead to raised levels of nitric oxide synthesis, and this, if sustained, causes a condition known as nitrosative stress. This has been strongly implicated as a cause of protein malfolding, a form of protein denaturation that occurs in the brains of Alzheimer’s patients (8, 9, 10). In fact, compounds that block nitrosative stress in the brain have been shown to slow and reverse the damage caused by Alzheimer’s in pre-clinical models (11).

Moderation in all things

The lesson of all this is moderation in all things, including natural things.

That includes l-arginine, a natural amino acid used by some to treat the vascular problem intermittent claudication (mentioned above), and to enhance male sexual function. As this compound is another potent source of nitric oxide, it also increases nitrosative stress (12), and will therefore, like beet juice, increase the risk of Alzheimer’s if used heavily.

Just as worryingly, l-arginine is widely used to treat the symptoms of vascular disease yet it has been implicated in increased death rates after heart attacks (13). The counter-arguments made by arginine sales-persons are not convincing, and certainly not enough to ignore the principle of due diligence.

By all means eat more beetroot in your healthy Mediterranean-style diet, but beware of too much concentrated beet juice.

Indeed, beware of ANY high-dose single-nutrient concentrates or supplements. As with foods, a wide range of nutrient supplements in moderate amounts is hugely preferable to an excessive intake of just one.


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Beetroot and beet juice - in moderation NutriShield Multi Vitamins and MineralsDr Paul Clayton’s best-selling book Health Defence is available from most good bookstores. See the website for excerpts and links to buy direct from the publisher.

See online here for delicious recipes from the Health Defence Cookbook  incorporating healthy foods featuring in a Mediterranean Diet. Beetroot and beet juice - in moderation NutriShield Multi Vitamins and Minerals


1. Bailey SJ, Winyard P, Vanhatalo A, Blackwell JR, Dimenna FJ, Wilkerson DP, Tarr J, Benjamin N, Jones AM. Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans. J Appl Physiol. 2009 Oct;107(4):1144-55

2. Bailey SJ, Fulford J, Vanhatalo A, Winyard PG, Blackwell JR, DiMenna FJ, Wilkerson DP, Benjamin N, Jones AM. Dietary nitrate supplementation enhances muscle contractile efficiency during knee-extensor exercise in humans. J Appl Physiol. 2010 Jul;109(1):135-48.

3. Vanhatalo A, Bailey SJ, Blackwell JR, DiMenna FJ, Pavey TG, Wilkerson DP, Benjamin N, Winyard PG, Jones AM. Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. Am J Physiol Regul Integr Comp Physiol. 2010 Oct;299(4):R1121-31

4. Larsen FJ, Weitzberg E, Lundberg JO, Ekblom B. Effects of dietary nitrate on oxygen cost during exercise. Acta Physiol (Oxf). 2007 Sep;191(1):59-66.

5. Webb AJ, Patel N, Loukogeorgakis S, Okorie M, Aboud Z, Misra S, Rashid R, Miall P, Deanfield J, Benjamin N, MacAllister R, Hobbs AJ, Ahluwalia A. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. Hypertension. 2008 Mar;51(3):784-90.

6. Kapil V, Milsom AB, Okorie M, Maleki-Toyserkani S, Akram F, Rehman F, Arghandawi S, Pearl V, Benjamin N, Loukogeorgakis S, Macallister R, Hobbs AJ, Webb AJ, Ahluwalia A. Inorganic nitrate supplementation lowers blood pressure in humans: role for nitrite-derived NO. Hypertension. 2010 Aug;56(2):274-81.

7. Presley TD, Morgan AR, Bechtold E, Clodfelter W, Dove RW, Jennings JM, et al. Acute effect of a high nitrate diet on brain perfusion in older adults. Nitric Oxide 2010 Oct 15, Published online ahead of print

8. Dildar K, Sinem F, Gökhan E, Orhan Y, Filiz M. Serum nitrosative stress levels are increased in Alzheimer disease but not in vascular dementia. Alzheimer Dis Assoc Disord. 2010 Apr-Jun;24(2):194-7.

9. Gu Z, Nakamura T, Lipton SA. Redox reactions induced by nitrosative stress mediate protein misfolding and mitochondrial dysfunction in neurodegenerative diseases. Mol Neurobiol. 2010 Jun;41(2-3):55-72. Epub 2010 Mar 25. Review

10. Nakamura T, Lipton SA. S-Nitrosylation of Critical Protein Thiols Mediates Protein Misfolding and Mitochondrial Dysfunction in Neurodegenerative Diseases. Antioxid Redox Signal. 2010 Sep 2. Epublished ahead of print.

11. Dumont M, Wille E, Calingasan NY, Nathan C, Flint Beal M, Lin MT. N-iminoethyl-L-lysine improves memory and reduces amyloid pathology in a transgenic mouse model of amyloid deposition. Neurochem Int. 2010 Jan;56(2):345-51.

12. Huang H-S, Ma M-C, Chen J. Chronic L-arginine administration increases oxidative and nitrosative stress in rat hyperoxaluric kidneys and excessive crystal deposition. Am J Physiol Renal Physiol 295: F388-F396, 2008

13. Schulman SP, Becker LC, Kass DA, Champion HC, Terrin ML, Forman S, Ernst KV, Kelemen MD, Townsend SN, Capriotti A, Hare JM, Gerstenblith G. L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial. JAMA 2006 Jan 4;295(1):58-64.

Best vitamins for men

Dr Paul Clayton 2014

In an ideal world, you would get all the nutrition you need from the food you eat. But these days that’s wishful thinking. It might well have been true 50 or 60 years ago, when men were far more physically active and ate more. More food means more nutrients.

Men need vitamins from supplements as they eat less
Today’s low energy, sedentary, and largely indoor lifestyles mean that most men have had to cut their average daily food intake to about 2,500 calories a day – or even less – if they are not to put on weight.

Less food means fewer nutrients. Even if you choose and mix your foods scrupulously, I calculate you cannot get a full range and amount of the most protective nutrients including essential vitamins at today’s calorie intakes.

The evidence supports this. According to the latest US Department of Agriculture surveys, men need to consume 350% more dark green vegetables and 150% more fruit per day in order to meet dietary guidelines. The situation is almost the same in the UK. In fact, men are deficient in most vitamin and minerals. And it gets worse.

RDAs are a minimum, not the amounts needed for optimal health
The survey only assessed men’s intakes of those vitamins and minerals for which there are RDAs – Recommended Daily Amounts. But these were established (mostly in the late ’60s) as the amounts needed in order not to develop a “deficiency” and its associated disease or health condition.

For example, the minimum daily requirement for Vitamin C is 60mg in the UK and 90 mg in the USA. Less than this amount over an extended period and you will develop scurvy. But although taking 60/90 mg will prevent scurvy, it is not necessarily the amount needed for optimal health. And scurvy is not a common disease!

Another example: Up to 70% of men in northern countries are deficient in Vitamin D in winter months. And low vitamin D is also associated with loss of bone density, increased risk of cancer, auto-immune disorders, Alzheimer’s disease and diabetes.

And these are just two of the vitamins for which there ARE RDAs.

Beyond the best vitamins to the best multi-nutrient supplements
We now know that some of the most important nutrients for long term health have not yet had RDAs established for them: such as the omega 3 fatty acids and the polyphenols, both of which have critically important anti-inflammatory properties.

Why do men need anti-inflammatory nutrients? Because they protect us against what’s called ‘chronic sub-clinical inflammation’, an insidious and invisible process that develops in our tissues and which is now known to drive all the degenerative diseases, from cancer to Alzheimer’s to heart disease, diabetes, arthritis and osteoporosis; not to mention sexual dysfunction, ageing of the skin, and indeed the bulk of the ageing process itself.

READ MORE on internal inflammation

There is overwhelming evidence that omega 3 fish oil is heart-protective, helps to protect brain function and has a role to play in reducing the risk of cancer. But few men have sufficient omega 3 in their normal diet. You would need to eat 3-4 portions of oily fish such as herring, mackerel, sardines or wild salmon (not farmed) a week.

There is equally good evidence to support the importance of polyphenols (a group of phyto-nutrients found in fruits and vegetables) to our long-term health. So much so that the American Cancer Society and many other authorities now recommend nine portions of fruit and vegetables a day!

The importance of combating internal inflammation
Omega 3s and polyphenols are important because they are anti-inflammatory nutrients which protect us from the silent danger of chronic sub-clinical inflammation; the trigger for the health problems we formerly assumed would inevitably increase with age. As Scientific American confirmed in a major review:

“Inflammation is an underlying contributor to virtually every chronic disease … rheumatoid arthritis, Crohn’s disease, diabetes and depression, along with major killers such as heart disease and stroke. The connection between inflammation and cancer has now moved to center stage in the research arena.”

We now know, however, that these dangers can be lessened by taking two simple steps. Firstly, we must reduce pro-inflammatory factors in our lifestyle, like high temperature cooking, fast foods, smoking and lack of exercise.

Men need anti-inflammatory nutrients from food and supplements
Secondly, we should increase the level of anti-inflammatory nutrients in our diet. That’s why eating more fruits, vegetables and oily fish is so important.

But as I said before, it’s difficult to get enough anti-inflammatory nutrients from food alone when we are only eating less than 2,500 calories a day. And that’s why I recommend taking nutritional supplements – some of the best are those which include polyphenols derived from curcumin, green tea and grapeseed extract.

Best supplements for men from your 30s upwards
You need anti-inflammatory vitamins and other nutrients even in your 30s and 40s, because over time, inflammation causes slowly progressive damage in the tissues. The symptoms of heart disease, for example, may only become overt in your 60s or 70s – but the damage leading up to the emergence of clinical symptoms will have been gradually accumulating for decades.

For men over 50, when the powers of healing and regeneration are no longer as effective as they were in youth, and testosterone levels reduce (the andropause), there are further protective supplement steps you can take.

For example, the evidence for the carotenoid supplements such as beta carotene, lutein and lycopene is persuasive. Lutein appears to have a protective effect for eyes and the laboratory research for the prostate protective effect of lycopene is increasingly convincing.

I would also add betaine. This is a little known nutrient, but in combination with certain B vitamins like folic acid it helps lower homocysteine levels – and lower homocysteine levels in the blood are linked to lower heart disease risk.

I would then add Co-enzyme Q10 – which helps the transfer of energy from food – and soy isoflavones. Soy isoflavones are one of the dietary elements that contribute to the generally better health and life expectancy of the Japanese men and women.

The lessons for men from the longest-lived healthiest societies in the world
All these nutrients occur in high levels in the diets of those societies that have a long life expectancy and health expectancy – and overall, it’s a combination designed to reproduce the elements in an ideal diet.

Although food and supplements cannot treat or cure age-related disease, they can create a climate in the body where disease is less likely to develop or worsen, and where the body’s own ability to heal itself is supported.

Are the best vitamins those which are labelled as exclusively for men?
No – don’t bother with vitamin and mineral supplements labelled as being exclusively for men. These are marketing gimmicks. We’re all human and we all need almost the same vitamins and minerals.

The only exception is iron. Excess iron in men can potentially accumulate to the point where it becomes pro-inflammatory and pro-oxidative, so you don’t need it. In fact it can be dangerous.

Don’t men need specialist vitamins too?
There are specialist supplements marketed for eyes, skin, bones, heart or brain. But why would you try to protect one vital organ and leave others undefended? Especially when the secret of brain, eye, heart and indeed sexual health, lies in reducing the tissue damage inflicted by chronic inflammation.

And don’t succumb to the more is better idea. Mega doses of individual vitamins or minerals can be dangerous.

You can now see why the best vitamins for men are NOT the A-Z pills, which have little impact on reducing long-term ag-related illness. They are only designed to avoid deficiency diseases. They have little or no anti-inflammatory effect and so cannot combat what is seen as the key driver of age-related health decline, namely chronic inflammation.

Only a comprehensive nutrient support programme can do that.