In addition to the above findings, the chemosensitization effects of beetroot in tumors also aroused great interest. Doxorubicin is an effective cytotoxic antitumor drug. It could be used clinically to treat various malignant tumor such as breast cancer, lung cancer, ovarian cancer, stomach cancer, and liver cancer (Cabeza etal., 2017; Dag etal., 2016; Marano etal., 2017). However, the use of doxorubicin is often accompanied by some side effects, significantly limiting its clinical application (Dag etal., 2016; Marano etal., 2017). At present, doxorubicin is mainly used in combination with other antitumor drugs. Studies have found that the antitumor efficacy was also improved by the combination of beetroot and doxorubicin. For instance, Sayantanee. Das et al. once studied the effects of co‐treatment with beetroot and doxorubicin on breast cancer cells MDA‐MB‐231 (Das etal., 2013 , 2016). The results in this study showed that the ROS level and cell apoptosis both were increased with treatment of beetroot in MDA‐MB‐231 cells. Similarly, in the breast (MCF‐7), prostate (PC‐3), and pancreatic (PaCa) cells, the co‐administration of doxorubicin with beetroot exhibited synergistic effect (Kapadia etal., 2013). Although Govind J. Kapadia et al. had previously declared that beetroot (betanin) exhibited significantly lower cytotoxicity compared with doxorubicin toward normal cells (Kapadia etal., 2011), it must continue to further explore the differential toxicity using doxorubicin alone or in combination with beetroot. Furthermore, the similar combined effects have been observed in studies using BC (Betacyanins) and XVX (Vitexin‐2‐O‐xyloside). A study by E. S. Scarpa et al. suggested that the combined use of XVX and BC caused an enhanced antitumor activity concerning the increased expression of pro‐apoptotic Bax, and downregulation of anti‐apoptotic BIRC5 (Survivin) and pro‐survival CTNNB1 (β‐Catenin) in T24 bladder cancer cells (Scarpa etal., 2016). Unlike the previous research of doxorubicin and beetroot, it also pointed out the combination of XVX and BC had no cytotoxic effect toward normal cells NCTC 2544 (Scarpa etal., 2016). However, it is not enough to use only one normal cell line to clarify their combination has less toxicity. It is necessary to offer toxicity assessment on other normal cells and carry out studies as supporting evidence in vivo. In another study, the scholars were not limited to research the combined effects of XVX and BC, betaxanthin (BX) that generated due to the resonance of double bond in BC was also involved (Farabegoli etal., 2017). It was found that double combinations of XVX and BC, XVX and BX or triple combinations of XVX, BC and BX all caused an increase in cytotoxicity toward CaCo‐2 cells. This probably attributed to betalains for its ability to reduce the mRNA level of COX‐2 and IL‐8. For chronic lymphocytic leukemia (CLL) patients, it has begun to be gradually accepted that the application of beetroot–carrot juice provided a successful treatment for the complementary or alternative therapy combined with chlorambucil, a conventional leukemic treatment drug (Shakib etal., 2015). This effect was proved by the decrease of the number of leukocytes, lymphocytes in peripheral blood and improve the relevant biochemical parameters.

Use and perception of complementary and alternative medicine among cancer patients: The CAMEO‐PRO study: Complementary and alternative medicine in oncology. Journal of Cancer Research and Clinical Oncology, 144, 2029–2047. 10.1007/s00432-018-2709-2 Since professional athletes’ bodies are already so efficient in oxygen exchange, the benefits they get from boosting their nitrate levels is smaller. Minimally processed beetroot waste as an alternative source to obtain functional ingredients. Journal of Food Science and Technology, 54, 2050–2058. 10.1007/s13197-017-2642-4It is reported that the function of lowering blood pressure by beetroot is associated with an ingredient isolated from beetroot that is dietary nitrate. Under the action of bacterial anaerobes situated on the tongue, the dietary nitrate would be activated into nitrite, thus exhibiting vasoprotective effects (Webb etal., 2008). The interruption of such conversion results in no obvious vasoprotective activity (Webb etal., 2008). Besides, in hypercholesterolemic patients, the alterations of oral microbiome would also influence the change from dietary nitrate to nitrite and therefore affects their vascular function (Velmurugan etal., 2016). In chronic hypertension in pregnancy, it also speculated that the differences in efficacy of nitrate supplementation were related to differences in the oral microbiome (Ormesher etal., 2018). In addition to having proven that the nitrate is the decisive form of beetroot to regulate the vascular function, the awareness of the impact of beetroot on microvascular vasodilation and arterial stiffness related to the vasoprotective effects is gradually increasing. Ditte A. Hobbs et al. found that the intake of nitrate in beetroot led to an increased curve area for endothelium independent vasodilation and decreased diastolic blood pressure (BP) in humans (Hobbs etal., 2012 , 2013). The results carried by Davi Vieira Teixeira da Silva's group indicated that the diastolic BP (5.2mmHg), systolic BP (6.2mmHg), and heart rate were decreased following the beetroot (nitrate) consumption in healthy subjects (Silva etal., 2016). The reduction of BP also was enhanced with beetroot supplementation following a moderate‐intensity aerobic exercise in obese individuals (Lima Bezerra etal., 2019). These findings have shown herein highlighted the testing of beetroot in vasoprotectiveness. Despite the above reports, the efficacy of beetroot in lowering blood pressure is affected by many other factors, such as age and sex (Coles & Clifton, 2012; Siervo etal., 2015). The presence of Glu298Asp polymorphism in the endothelial NO synthase (eNOS) gene also affects the postprandial blood pressure response to dietary nitrate‐rich beetroot bread (Hobbs etal., 2014). Recent research has raised different perspectives on the effects of beetroot diets on lowering blood pressure; that is, the consumption of raw beet juice (RBJ) and cooked beet (CB) has a difference in antihypertensive effects. The group of S. Asgary et al. once made a research and found that compared to CB, RBJ had a stronger antihypertensive effect in hypertensive subjects (Asgary etal., 2016). While regarding the reason for the different effect between CB and RBJ, it requires to be further studied. Apart from the above findings, the key problem regarding the beetroot is to clarify the activity on treating hypertension, despite it is generally considered playing a role in lowering blood pressure. Research once pointed that the normalization of mRNA expression in CTGF, MCP‐1, and MMP‐2 followed by beetroot treatment would lead to the improvement of the hypertension in rat model, and this effect was induced by nitrate rather than betaine (Bhaswant etal., 2017). Nevertheless, in the study of patients with hypertension, Bondonno et al. pointed out that there was no significant improvement of hypertension after beetroot intake (Bondonno etal., 2015). C. P. Kerley et al. stated briefly that the function of beetroot in antihypertensive was achieved only among those patients with uncontrolled hypertension (Kerley etal., 2017). The improvements in muscle microvascular function were also observed in never‐treated hypertensives (Zafeiridis etal., 2019). In addition, research provided evidence that nitrate‐rich beetroot had an acute effect on circulating immune cells and platelets in older adults owing to decreased blood monocyte‐platelet aggregates and reduced blood CD11b‐expressing granulocytes (Raubenheimer etal., 2017). In the subsequent study, therefore, the group determined to study whether the consumption of beetroot could reduce the risk of hypertension.

Ergogenic effects of beetroot juice supplementation during severe‐intensity exercise in obese adolescents. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 315, R453–R460. 10.1152/ajpregu.00017.2018 The interest in various nutrients for improving athletic exercise performance has increased in recent years (Berry etal., 2015). Due to the approved dietary nitrate on physical performance, nitrate‐rich beetroot thus attracts considerable attention. It is recognized that dietary nitrate decomposes into nitrite and subsequently converts to nitric oxide (NO) and other nitrogen‐active intermediates that affect the physical performance of athletic populations (Ferguson etal., 2013). However, NO may lead to the formation of N‐nitroso compounds (NOCs) following a secondary pathway, making it be cautious with beetroot intake (Berends etal., 2019). Up to now, many studies have been conducted on the impact of beetroot in the exercise performance of multifarious subjects. Once consumed, nitrate is converted in the mouth and stomach to nitric oxide (NO). NO has several roles in the body but importantly acts as a vasodilator, opening blood vessels and allowing more blood and oxygen to be delivered to muscles. Nitrate may also reduce the energy cost of exercise and positively affect muscle contraction. Who might benefit from Nitrate supplementation A daily glass of beet juice can provide you with a boost of energy and improve your stamina. That same nitrate that’s converted to nitric oxide to help lower blood pressure can also increase the uptake of oxygen while you’re active and exercising, making you less tired throughout the day. Prevent iron deficiencies and anemia Dietary nitrate improves vascular function in patients with hypercholesterolemia: A randomized, double‐blind, placebo‐controlled study. American Journal of Clinical Nutrition, 103, 25–38. 10.3945/ajcn.115.116244

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We also find quite a lot of variability between people. Some people have more effective mouth bacteria and other people are better able to take nitrate up in their muscles. Some people are super-responders. That’s the same with any nutritional ergogenic aid, whether it’s caffeine or bicarbonate or creatine– you tend to find that some people respond better than others. Those that are prone to kidney stones may be at a higher risk for kidney stones with excessive consumption of beet juice. Beets have a high concentration of oxalates and these could stay in the body, resulting in kidney stones for those that are not careful. These precautions are for the most part mild, but worth considering all the same. Make Your Own Beet Shots Betacyanins enhance vitexin‐2‐O‐xyloside mediated inhibition of proliferation of T24 bladder cancer cells. Food & Function, 7, 4772–4780. 10.1039/C6FO01130F Beetroot juice is more beneficial than sodium nitrate for attenuating muscle pain after strenuous eccentric‐bias exercise. Applied Physiology, Nutrition and Metabolism, 42, 1185–1191. 10.1139/apnm-2017-0238

Absence of an effect of high nitrate intake from beetroot juice on blood pressure in treated hypertensive individuals: A randomized controlled trial. American Journal of Clinical Nutrition, 102, 368–375. 10.3945/ajcn.114.101188 Beetroot improves oxidative stability and functional properties of processed foods: Singular and combined effects with chocolate. Journal of Food Science and Technology, 55, 2401–2409. 10.1007/s13197-018-3157-3 Beetroot ( Beta vulgaris L.) and naturally fermented beetroot juices from organic and conventional production: Metabolomics, antioxidant levels and anticancer activity. Journal of the Science of Food and Agriculture, 94, 2618–2629. [ PubMed] [ Google Scholar]Beetroot ( Beta vulgaris) rescues mice from γ‐ray irradiation by accelerating hematopoiesis and curtailing immunosuppression. Pharmaceutical Biology, 55, 306–319. [ PMC free article] [ PubMed] [ Google Scholar] You can safely drink beet juice shots and eat beets every day, with as many shots as you want. Some studies have indicated that beet shots should be consumed two to three hours before a workout or athletic performance. The same timing could be said if you want to consume beet shots for brain power or brain performance.

Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, 309, R459–R466. 10.1152/ajpregu.00099.2015Acute ingestion of beetroot bread increases endothelium‐independent vasodilation and lowers diastolic blood pressure in healthy men: A randomized controlled trial. Journal of Nutrition, 143, 1399–1405. 10.3945/jn.113.175778 Protection of Erwinia amylovora bacteriophage Y2 from UV‐induced damage by natural compounds. Bacteriophage, 5, e1074330. [ PMC free article] [ PubMed] [ Google Scholar] Petróczi, Andrea, and Declan P. Naughton. “Potentially fatal new trend in performance enhancement: a cautionary note on nitrite.” Journal of the international society of sports nutrition 7, no. 1 (2010): 25.