Phosphoric acid and citric acid are predominant in beetroot juice, followed by oxalic acid and malic acid. Subsequently, shikimic acid, the precursor for the synthesis of aromatic amino acids such as phenylalanine, tyrosine and tryptophan, and betalains, are detected in high concentrations in organic and conventional farming beets, while citric acid, malic acid, and fumaric acid are also observed, but at lower concentrations [ 39]. Malic acid is present at the highest concentrations in beetroot formulations, including juice, chips, powder, and cooked vegetables, followed by citric acid and ascorbic acid [ 18]. dos Santos BD, Conte-Junior CA, Paschoalin VMF, Alvares TS. Quantitative and comparative contents of nitrate and nitrite in beta vulgaris L. by reversed-phase high-performance liquid chromatography-fluorescence. Food Anal Methods. 2016;9(4):1002–8. BVEE beverage (250 and 500 mg/kg, p.o) was also suggested to be practical on kidney lipid peroxidation factors. The activity level of catalase, as an important antioxidant enzymes, was reduced by 27.97% following GM treatment, and notably increased by 83.92 and 92.62%, respectively, following the administration of 250 and 500 mg/kg BVEE. Similar trend was present for NP- SH content (non- protein sulfhydryl- for the measurement of renal non- protein sulfhydryl); a reduction of 37.94% following 85 mg/kg GM treatment was present, comparing to 71 and 81.71% increase in 250 and 500 mg/kg BVEE, respectively. The total protein content of GM treated animals was decreased by 71.46% in comparison with a dose dependent increase in pretreated groups of 250 mg/kg and 500 mg/kg BVEE by 37.35 and 43.74%, respectively [ 79]. Moreover, various commercial organic and conventional beetroot juices, are reported to contain total sugar, vitamin C and total flavonoids within a range of 1.73–7.85 g, 10.75–20.36 mg, and 2.02–2.36 mg (per 100 g), respectively [ 12]. Betalains make up to ~ 70–100% of phenolic composition of beetroot, limited to 0.8–1.3 g/L of fresh beetroot juice (about 60% betacyanins and 40% betaxanthins) [ 1]. Chang PY, Hafiz MS, Boesch C. Beetroot juice attenuates glycaemic response in healthy volunteers; 2018.

Varner AS. Modeling and optimization of the dehydration of beets for use as a value- added food ingredient; 2014. Pour the beetroot juice into a glass, and immediately drink it or place it in the refrigerator to chill. Chhikara N, Kushwaha K, Sharma P, Gat Y, Panghal A. Bioactive compounds of beetroot and utilization in food processing industry: a critical review. Food Chem. 2018;272:192-200. As a counterpoint, despite elevations in plasma NO 2 concentration, no significant decrease of blood pressure has been admitted in diabetic patients supplemented with 250 mL beetroot juice for 2 weeks. The reason for this discrepant result is unclear but may reflect the study methodology, related to concomitant medications or aberrant vascular physiology in diabetic patients [ 28]. The beetroot-cereal bar and beetroot-gel designed for NO 3 − supplementation included the binding phase ingredients or carboxymethyl cellulose, respectively, increasing carbohydrate content and energy but maintaining low lipid concentrations in both formulations. The beetroot cereal-bar and gel are considered low-fat foods, according to Brazilian legislation for solid foods [ 29], but low lipid contents did not compromise the sensorial characteristics of these beetroot intervention products, such as flavor, texture, color, and aroma.

Hughes WE, Ueda K, Treichler DP, Casey DP. Effects of acute dietary nitrate supplementation on aortic blood pressure and aortic augmentation index in young and older adults. Nitric Oxide. 2016;59:21–7.

Hypotensive effect of beetroot seems to be highly influenced by physiological and medical status. Beetroot juice administration was found to exert a much stronger effect on blood pressure in hypertensive compared to normotensive subjects, which can be explained by the rate of erythrocyte xanthine oxidase expression (XOR - Erythrocytic Xanthine Oxidoreductase, an enzyme involved in reduction of NO 2 in active NO) in hypertensive states [ 40]. Govoni M, Jansson EÅ, Weitzberg E, Lundberg JO. The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. Nitric Oxide. 2008;19(4):333–7. Additionally, the oxalic acid constitution of beetroot is relatively abundant [ 13]; average content in raw beetroot and beetroot juice equals to 94.6–141.6 mg/100 g and 300–525 mg/L, respectively. Oxalic acid, as a metal ion chelator, promotes the formation of nephroliths, and therefore, is considered as a health concern especially in patients predisposed to the kidney disease [ 1, 14].There is limited evidence in regards to the adverse effects and tolerance issues of beetroot juice and its components. Exclusive number of studies reported major negative implications associated with the consisting bioactive compounds, out of which, 5 studies were assessed in our review. copper, which plays a role in making collagen, maintaining bones and blood vessels, and supporting immune function