The red, golden, and candy cane beets are the perfect addition to any winter menu. Beets are the ideal vegetable to incorporate into your winter meals to add immune-boosting, phytonutrient-rich compounds into your diet. With the cold and flu season upon us, it is time to look to the foods we eat as a weapon and take advantage of their potential to keep us healthy. Beets are packed with phytonutrients that have unique antioxidant and anti-inflammatory properties. Phytonutrients, as defined by the US Department of Agriculture (USDA), are organic components found in fruits, vegetables, legumes, grains, nuts, and tea shown to promote human health.1 Beets contain flavonoids (or polyphenols) and carotenoids, 2 common classes of phytonutrients. Phytonutrients protect our health through a variety of mechanisms. Based on current and ongoing research, the USDA proposes that phytonutrients protect our health by serving as antioxidants, enhancing immune response and cell-to-cell communication, altering estrogen metabolism, converting betacarotene to vitamin A, causing apoptosis in cancer cells, repairing DNA damage caused by smoking and other toxic exposures, and detoxifying carcinogens through the activation of specific enzyme systems.1 The botanical name of the beet is Beta vulgaris, and it belongs to the chenopod plant family that also includes Swiss chard and spinach. Beets are unique in that their vibrant red-purple and yellow pigments do not primarily come from the more commonly known phytonutrients called anthocyanins but rather from betalains. The 2 main types of betalains are betacyanins and beta xanthins. The deep red-purple hued beets obtain their color from betacyanins. The most studied form of betacyanins is betanin. The yellow beet owes its golden color to betaxanthins. Most research studies have focused on the betaxanthin called vulgaxanthin. Both of these pigments are water-soluble and often added as a natural food coloring to many commercial food products. The beet root is not the only source of antioxidant phytonutrients found in beets, as the leafy greens offer a wealth of nutrient-packed compounds as well. Beet greens are an excellent source of flavonoids and the carotenoids beta-carotene, lutein, and zeaxanthin. These antioxidant carotenoids may have a positive impact on improving overall eye health and in the prevention of chronic age-related eye conditions.2 Betaine is yet another phytonutrient inherent in beets that in a recent epidemiologic study exhibited the ability to reduce inflammatory markers such as homocysteine, C-reactive protein, interleukin- 6, and tumor necrosis factor-a.3 These inflammatory markers are risk factors for the development of cardiovascular and other chronic conditions. Additional re search is needed on this topic, however, the preliminary findings make a compelling argument to include betaine-rich beets in your daily diet to promote optimal health.3 The antioxidant content of the beet root and greens have made them the focus of numerous research studies focusing on their anticancer benefits. A recent study compared the cytotoxic effect of red beetroot extract to doxorubicin in human prostate and breast cancer cell lines. Interestingly, the beetroot extract and doxorubicin both exhibited a dose-dependent cytotoxic effect in both the prostate and breast cancer cell lines tested. Doxorubicin completely inhibited the growth of the prostate cancer cells, while at the same concentration the beetroot extract was able to decrease the growth rate of those cancer cells. Conventional treatment remains most effective, but these results show the potential power of the beetroot extract’s anticancer benefit. Betanin, most likely the major betacyanin component in beetroot extract, may be responsible for these cytotoxic effects.4 This is an exciting result, as it presents the possibility of using foods in conjunction with conventional treatments to augment their effect or perhaps even lessen the toxicities of these treatments. Another study showed that betanin pigments have the ability to inhibit tumor growth in cancer cells of the breast, colon, stomach, central nervous system, and lung.5 In this study, betanin also inhibited the action of proinflammatory enzymes.5 Esophageal cancer was also thwarted by the chemopreventive properties of beetroot. 6 This animal study found that red beetroot food color that contains betanins was able to reduce esophageal cancer cell proliferation, angiogenesis, and inflammation as well as stimulate apoptosis. These findings also raised the question of whether there could be other active components within the beetroot that work synergistically with the betanins to provide protection against cancer initiation and growth.6 Many of the studies have been epidemiologic or laboratory studies; however, the results have been very promising and hopefully will proceed to larger, randomized controlled studies that use human subjects to validate the health potential of beets. These preliminary studies can provide patients with an opportunity to incorporate specific foods into their diet that have the potential to augment their treatment as well as empower them as being active participants in their own cancer treatment plan. In addition to the variety of phytonutrients abundant in beets, the root and long, leafy green stems provide numerous vitamins and minerals essential to the proper functioning of our bodies. Beets are an excellent source of folate and a good source of manganese, iron, vitamin C, vitamin A, vitamin K, potassium, and niacin. Dietary fiber is another added benefit to consuming the beet root and greens. Fiber has the distinct ability of eliminating unwanted toxins from the body, thereby reducing the risk of colon cancer. In an animal study, beet fiber was shown to reduce the incidence of precancerous colonic lesions.7 Dietary fiber can also help to manage cholesterol levels, prevent certain gastrointestinal ailments such as constipation, and improve glycemic control in diabetics. If patients are at risk for developing constipation due to treatment modalities or the use of pain medications, adequate fiber, such as the beet root and greens, as well as adequate fluid intake can be the key to prevention and management of this nagging condition that can impact their overall quality of life. Beets can also be a useful addition to the dietary habits of colon cancer survivors or to people with an increased risk of colon cancer due to family history or lifestyle factors. Beets are in peak season from June through October. Purchase beets that are small, round, and firm without any blemishes or cuts and leaves that are bright and green. To prepare beets for storage, trim the green leaves about 2 inches from the root, as the leaves will pull moisture away from the root. The beet greens can be placed in a plastic bag, unwashed, and stored in the refrigerator for 2 to 4 days. The beet root can be stored in the refrigerator in a plastic bag, unwashed, for 10 to 14 days. The long tail attached to the root should not be trimmed, but purchasing roots with an excess amount of hair should be avoided as this may be an indication of toughness and age. Although beets appear firm and hearty, they are actually very delicate and temperature sensitive. The betalain content in beets decreases as the cooking time increases. To retain most of the beet nutrients, bake, steam, or boil them unpeeled, limiting roasting time to less than an hour and steaming time to less than 15 minutes. Canned beets remain a good source of folate and moderate amounts of vitamin C, manganese, iron, copper, and magnesium. One cup of cooked beets contains about 2 g of protein, 2 to 3 g of fiber, less than 1 g of fat, and 14 to 16 g of carbohydrate, and approximately 74 calories.8 Beet greens are also low in calories, as a half-cup serving has about 19 calories and provides an excellent source of carotenoids, flavonoids, vitamin A, and vitamin K. They can be prepared like Swiss chard—sautéed or boiled. This nutrient profile makes beets an easy addition to most diets. Consumption of beets can cause urine and bowel movements to become red or pink in color. This condition is usually harmless; however, if patients are at risk for bleeding or have certain urinary, gastrointestinal, or surgical issues, avoiding beets at that time may be an appropriate course of action. It can be unsettling for some patients to see this change in urine or bowel movement, and any potential positive impact beets may have on their overall health may not be as important as alleviating their anxiety. Patients with a history of oxalate urinary tract stones should avoid consuming a large amount of beet greens as they are high in oxalic acid and may exacerbate this condition. The wide variety of phytonutrients, vitamins, minerals, and fiber that the beet root and greens have to offer make this vegetable an extraordinary addition to any healthy meal plan. Try to incorporate beets into the diet at least once or twice per week in order to obtain their maximum benefit. Canned beets can be used to fulfill this quota, but there are many ways to add raw and fresh-cooked beets into the diet. Add shredded raw beets to your favorite coleslaw recipe or turn roasted beets into a smooth dressing to top off your salad or side of sautéed beet greens. Be creative and think outside the can—freshly prepared beets are a bounty of goodness.
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