What are the benefits of taking beet gummy supplements for cardiovascular health?

Beet Gummy Benefits for Cardiovascular Health

Beetroot supplements, including gummies, may modestly reduce blood pressure through nitrate-mediated increases in nitric oxide, but they should not replace proven cardiovascular therapies and have significant limitations in standardization and clinical evidence.

Blood Pressure Reduction

• Beetroot juice containing 5-9 mmol of nitrate (310-560 mg) can reduce systolic blood pressure by approximately 4-5 mmHg when consumed 2-3 hours before measurement 1
• This effect appears to work through increasing tissue nitrite and nitric oxide, which reduces the oxygen cost of exercise and enhances vascular function 1
• In randomized controlled trials, beetroot juice reduced systolic blood pressure in young Black and White males by approximately 4 mmHg, though notably this effect was only observed in males, not females 2
• A systematic review of trials from 2008-2018 demonstrated that beetroot juice supplementation can reduce blood pressure in healthy subjects, pre-hypertensive populations, and even diagnosed hypertensive patients 3

Critical Limitations of Beet Gummies

The major problem with beet gummy supplements is extreme variability in nitrate content—the active ingredient responsible for cardiovascular benefits:

• Analysis of 45 different lots from 24 beetroot products showed a ~50-fold range in nitrate content between the lowest and highest products 4
• Even within the same product brand, there was moderate-to-large variability with a mean coefficient of variation of 30±26% (range 2-83%) 4
• Only 5 out of 24 products consistently provided ≥5 mmol of nitrate per serving, which appears to be the minimal effective dose 4
• Gummy formulations are particularly problematic as they typically contain far less beetroot extract than liquid juice concentrates

Dose-Response Relationship

• A minimum of 8.4 mmol nitrate (approximately 140 ml concentrated beetroot juice) is needed to reduce oxygen cost during exercise by 1.7% 5
• Doubling the dose to 16.8 mmol nitrate reduced oxygen cost by 3.0% and extended exercise tolerance by 12-14%, but provided no additional benefit beyond the 8.4 mmol dose 5
• Lower doses of 4.2 mmol nitrate (70 ml) showed no significant physiological effects 5
• Peak plasma nitrite concentrations occur 2-3 hours after ingestion, making timing important for any potential benefit 5

Guideline Position on Supplements

Major cardiovascular societies explicitly recommend against relying on dietary supplements for cardiovascular protection:

• The American Heart Association and American College of Cardiology state that nonprescription dietary supplements are not beneficial to reduce the risk of acute cardiovascular events in patients with chronic coronary disease 6
• The European Society of Cardiology guidelines recommend against vitamin or micronutrient supplementation to reduce cardiovascular disease risk 6
• Dietary supplements have insufficient evidence to support their use for cardiovascular event reduction, and some supplements may even be harmful 1, 6

Specific Context for Post-COVID Cardiovascular Symptoms

• For patients with post-acute sequelae of COVID-19 experiencing chest pain with suspected microvascular dysfunction, beetroot extract can be taken 1 hour before exercise to achieve maximal vasodilation 1
• This represents one of the few specific clinical contexts where beetroot supplementation is mentioned in recent guidelines, though it is listed as an option for refractory symptoms after other therapies have failed 1

What Should Be Prioritized Instead

The American Heart Association and American College of Cardiology recommend prioritizing evidence-based interventions:

• A Mediterranean diet rich in vegetables, fruits, legumes, nuts, whole grains, and lean protein provides cardiovascular benefits through multiple mechanisms 6
• Consuming whole beetroot and other high-nitrate vegetables (spinach, rocket salad, celery) as part of a regular diet provides a "food first solution" for chronic nitrate intake 1
• Proven medical therapies including statins, antiplatelet agents, blood pressure medications, and diabetes management should never be substituted with supplements 6

Common Pitfalls to Avoid

• Do not assume all beet gummy products contain therapeutic amounts of nitrate—most likely do not 4
• Avoid recommending beetroot supplements to females expecting the same blood pressure benefits seen in males, as sex differences in response have been documented 2
• Do not use beetroot supplements as a substitute for established cardiovascular medications or lifestyle modifications 6
• Be aware that beetroot juice may discolor urine, which can cause unnecessary patient concern 1
• Individual response to nitrate supplementation varies considerably, with some patients showing minimal benefit 1

Bottom Line for Clinical Practice

While beetroot juice containing adequate nitrate (≥8.4 mmol) may modestly reduce blood pressure through nitric oxide-mediated mechanisms, beet gummies are unlikely to provide consistent cardiovascular benefits due to highly variable and typically insufficient nitrate content. Patients seeking cardiovascular benefits should focus on consuming whole vegetables high in nitrates as part of a Mediterranean-style diet pattern, combined with proven medical therapies when indicated 1, 6.