Your Mom Was Right – Eat Your Beets, They’re Good for Your Heart

By Bianca Garilli, ND

From Metagenics Institute

I have a patient who doesn’t like vegetables. In fact, this person is also not a fan of water (sans flavoring), exercise, nor high fiber foods such as legumes. This scenario is, in many ways, a perfect setup for a number of lifestyle-related chronic diseases, including hypertension. This patient has been on a cocktail of medications for many years but expressed to me that they’d like reduce the list. So, it was with great excitement that I recently shared emerging research on a natural, food-based approach for reducing blood pressure with this individual.

But, first, a little science background. Nitric oxide or NO, is an important signaling molecule in humans and is required for a large number of reactions and biochemical pathways in the body. NO can be made by the body (endogenously) through various, intricate enzymatic pathways and also through non-enzymatic pathways which require precursor nitrates and nitrites.1 One of the best sources of nitrates is the diet; beetroot and leafy greens such as arugula and spinach being some of the highest sources of dietary nitrates.1 After consumption, the dietary nitrate molecules are metabolized by oral bacteria into nitrites which are then endogenously transformed into the cardioprotective NO molecule.2-3

As noted above, NO plays a critical role in cardiovascular health. For example, low levels of NO in the body can lead to various pathologies, most notably endothelial dysfunction which contributes to hypertension and atherosclerosis; low NO has also been found to play a role in diabetes and hypercholesterolemia.1

In contrast, healthy levels of NO in the body support vascular tone, healthy blood flow, leukocyte adhesion, and platelet aggregation.Consuming food-based nitrates on a routine basis, then, would seem to be a logical next step for those desiring to prevent or treat NO deficiency-related disease processes. And, in fact, that logic is backed by science, which is the exciting new research I was hoping to share with the unnamed individual mentioned earlier.

A recent study published in Nutrition Reviews presents a systematic review and meta-analysis including 23 studies that measured blood pressure, endothelial function, arterial stiffness, platelet aggregation, and/or blood lipid outcomes in response to oral inorganic nitrate/nitrite intake.4 The analyses demonstrated that inorganic nitrate intake significantly reduced resting blood pressure, improved endothelial function (measured as flow-mediated dilatation), arterial stiffness, and platelet aggregation.4

Many of the studies in this review, utilized beets and beetroot juice as their sources for nitrates in their research. I don’t know about you, but my mother always made sure I ate my beets. These colorful root vegetables have leaves that are also edible and are classified in the Amaranthaceae family, the same family as quinoa, spinach, and lamb’s quarters (AKA wild spinach).5

One of the beetroot studies was a double-blind, placebo-controlled clinical trial that randomized 68 hypertensive individuals 18-85 years of age to one of two groups: 250 mL/day of beetroot juice or the “placebo”250 mL/day of nitrate-free beetroot juice for 4 weeks.6 Participants consumed their respective drinks daily for 4 weeks; this was preceded by a 2-week run-in period followed by a 2-week wash-out period. The trial found that daily supplementation with dietary nitrate from beetroot juice was associated with a reduction in blood pressure: systolic ↓7.7-8.1mmHg; diastolic ↓2.4-5.2mmHg.6 Additionally, endothelial function improved by approximately 20% and there was a reduction in arterial stiffness by 0.59m/s.6

These clinical trial findings are in agreement with a review and meta-analysis7 that analyzed results from multiple studies investigating the therapeutic benefits of beetroot juice supplementation on blood pressure. This review found an overall reduction in systolic and diastolic blood pressure of 3.55 mmHg and 1.32 mmHg, respectively, and these reductions were significantly greater in the beetroot juice supplemented groups vs. control groups.7 This same publication also noted greater improvements in blood pressure with higher (500 mL/day) vs. lower (70-140 mL/day) beetroot juice doses or with longer periods of consumption (≥2 weeks vs. <2 weeks).7

So, as in every good story, there is a moral. First and foremost – listen to your parents. Next, make your plate colorful and eat your vegetables, every day and lots of them. Finally, incorporate beets and other high-nitrate foods such as spinach and arugula into your healthful diet.


  1. Luiking YC et al. Regulation of nitric oxide production in health and disease. Curr Opin Clin Nutr Metab Care. 2010; 13(1): 97–104.
  2. Hobbs DA et al. Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects. Br J Nutr. 2012;108(11):2066-74.
  3. Khatri J et al. It is rocket science – why dietary nitrate is hard to “beet”! Part I: twists and turns in the realization of the nitrate-nitrite-NO pathway. Br J Clin Pharmacol. 2017;83(1):129–139.
  4. Jackson JK et al. The role of inorganic nitrate and nitrite in cardiovascular disease risk factors: a systematic review and meta-analysis of human evidence. Nutr Rev. 2018;76(5):348-371.
  5. Encyclopedia Brittanica. Amaranthaceae. Accessed July 26, 2018.
  6. Vikas K et al. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015;65(2):320–327.
  7. Bahadoran Z et al. The nitrate-independent blood pressure-lowering effect of beetroot juice: a systematic review and meta-analysis. Adv Nutr. 2017;8(6):830-838.

3 Reasons Lack of Sleep May Cause Weight Gain

From Metagenics Institute

If you’re trying to maintain a healthy weight, counting sheep may be as important as counting the carbs on your plate or weight repetitions at the gym. Because, while physical activity and a balanced diet are key factors, sleep may be the most overlooked aspect of your weight management plan.

Can you sleep your way to your dream body? Perhaps not. But if you are sleep deprived, more sleep may help you reach your weight goals. Here’s what you need to know about the sleep-weight connection.

Are you sleep deprived?

The National Sleep Foundation recommends seven to nine hours of sleep per night for adults 24-64, slightly more for younger adults and a bit less for those older.1 But due to electronic gadget lights, chronic stress, habitual caffeine, shift-work, and many other reasons, few folks get their target rack time. In fact, according to the Centers for Disease Control and Prevention (CDC), insufficient sleep is a public health problem2 with serious concerns for our productivity, safety, and health—including your waistline.

It’s not just you

If you’re sleep deprived and find yourself battling the bulge, you’re in good company. Studies have found consistency in the sleep-weight connection; sleep deficiency is linked to weight gain. The largest study of its kind involved over 200 participants and simulated a sleep-restricted workweek. It compared the effects of restricting sleep to only four hours per night compared to unrestricted sleep, up to ten hours per night.3 After only five days, the sleep-restricted subjects had gained about 2 pounds. In contrast, the control group, allowed to sleep for up to 10 hours a night, gained virtually no weight.

If sleep restriction can cause you to gain two pounds in just five days, what can happen on the scale long-term?

A lot, according to women tracked for 16 years in The Nurses’ Health Study. Women reporting six hours of sleep per night were 12% more likely to gain at least 30 pounds during the study compared to the women who slept seven hours per night. But those women who were even more sleep deprived, reporting no more than five hours per night, were 28% more likely to gain at least 30 pounds during that same period!Apparently, with the sleep-weight connection, every hour counts.

How does less sleep = less svelte?

There are several underlying factors behind the sleep-weight connection. But a common thread is our own chemistry, which almost seems to revolt when restorative sleep is intentionally or unintentionally withheld. It’s you against them—and it’s not a fair fight.

Getting to know your hunger chemistry

There’s more than your sensation of fullness and stomach-brain communication involved. Rather, when it comes to hunger regulation and sleep, we have several chemical messengers at play. And when it gets complicated between you and the sandman, those messengers are not on your side. So get to know them:

  • Ghrelin: When ghrelin, known as the “hunger hormone,” is released from the stomach, it sends your brain a “feed me” signal. It signals not only when to eat, but also when to switch from burning calories to storing them as fat. Ghrelin naturally decreases after a meal and remains lower while you sleep, when caloric needs are less. But less sleep means more ghrelin.
  • Leptin: The opposite of ghrelin, leptin, is known as the “satiety hormone,” as it plays a crucial role in appetite and weight control. Released from fat cells, leptin crosses the blood-brain barrier and signals, ‘‘We’re good here. Put the fork down.” It also stimulates fat burning to create energy. Leptin levels naturally increase after a meal and remain elevated while you sleep, until you awaken and your metabolism increases. But less sleep means less leptin. Making things even trickier, sometimes leptin is secreted, but the brain’s not getting its signals. Think boy who cried wolf. This situation, known as “leptin resistance” can mean there is an underlying insulin resistance, a sign of disordered blood sugar metabolism, which puts you at risk for obesity and metabolic syndrome. While research on how to reverse leptin resistance is limited, animal studies show that an unbalanced diet can cause leptin resistance.5 So a dietary approach to reducing the underlying insulin resistance is a logical start.

As you can see, proper balance of ghrelin and leptin is very sleep-dependent. And for the caveman, perhaps these hormones were key to survival during the shorter, sleep-heavy but food-poor days of winter. They also played a part in the ability to capitalize on the longer, lighter sleep and more food-abundant days the rest of the year.

Today, our sleep-deprived bodies are prone to having too much ghrelin and not enough leptin. The result is that the body doesn’t feel satiated, thinks it’s hungry, and needs more calories—and squirrels away those calories for the long winter. In short, ghrelin and leptin kept the caveman alive, but they may be making you heavy.

  • Endocannabinoids: “It’s 1 AM, and I’m craving a salad,” said no one ever. If you’ve ever experienced sleepiness munchies, blame it on endocannabinoids. Sound vaguely familiar? Endocannanbinoids are the endogenous version of the cannabinoids in marijuana—our bodies can generate a very close facsimile of the previously illegal (in some states) substance. Endocannabinoids bind to the same receptors in the brain, fat cells, muscles, and elsewhere, causing a similar appetite-inducing effect as cannabis.6 Further, the endocannabinoid system interacts with your dopamine and opioid pathways, driving not just hunger, but according to some studies cravings for high-carb and high-fat.7 You want cookies. Now. Resistance is pretty much futile.

What to do?

That depends. There are two main reasons behind sleep deprivation. Either you have a sleep hygiene issue (trouble falling asleep or staying asleep), or you have a scheduling issue, in that your lifestyle is interfering with adequate sleep.

For sleep hygiene issues, the typical recommendations always merit consideration: limiting caffeine, avoiding blue light before bed, creating a cool and dark environment, etc. But, when you have a scheduling challenge, getting adequate sleep requires some lifestyle restructuring. It’s worth the time to re-engineer your schedule to slowly go to bed earlier or rise later to increase your sleep time. But in the meantime, can you catch up on sleep on the weekends?

Weekend catch-up sleep: is it a real thing?

Of course, you can get extra sleep on the weekend. But can it potentially reverse your Monday-Friday sleep deprivation? Perhaps. In a study of over 2,000 people participants, those who slept longer on the weekends, nearly two hours longer on average, had a significantly lower body mass index (BMI) than those who didn’t. Further, it appears that the sleep: BMI relationship was dose-dependent in that every extra hour of weekend catch-up sleep was associated with a significantly lower body mass.8 So catch-up sleep can indeed be a good strategy. That is, if your overall average sleep for the week puts you out of the red and into the black, as in you’ve paid back your sleep debt.

Sleep more. Weigh less. Not convinced? Sleep on it…


  1. National Sleep Foundation. National Sleep Foundation Recommends New Sleep Time. Accessed July 19, 2017.
  2. CDC. Insufficient sleep is a public health problem. Accessed July 19, 2017.
  3. Spaeth AM et al. Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults. Sleep. 2013;36(7):981-990.
  4. Patel SR et al. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006;164(10):947-954.
  5. Vasselli JR et al. Dietary components in the development of leptin resistance. Adv Nutr. 2013;4(2): 164-175.
  6. Hanlon EC et al. Sleep restriction enhances the daily rhythm of circulating levels of endocannabinoid 2-arachidonoylglycerol. Sleep. 2016;39(3):653–664.
  7. De Luca MA et al. Cannabinoid facilitation of behavioral and biochemical hedonic taste responses. Neuropharmacology. 2011;63(1):161–8.
  8. Im HJ et al. Association between weekend catch-up sleep and lower body mass: population-based study. Sleep. 2017;40(7):zsx089.