What’s so great about beets?

Beets are rich in powerful antioxidants and nutrients that have been linked to a number of health benefits.

Here’s a look at the health benefits of beets, including the positive effects of beets for people with diabetes.

Beets may help lower blood sugar and insulin

Beets are rich in phytochemicals that have been shown to have a regulating effect on glucose and insulin in humans.

A 2014 study investigated the effects of beetroot juice on blood glucose levels after eating. The study found that drinking 225 milliliters of beetroot juice, or a little less than a 1/2 cup, resulted in a significant suppression of post-meal glucose levels.

However, it’s important to note that this study was done with participants who didn’t have diabetes. More research is needed that includes individuals with a diabetes diagnosis before definitive claims can be made.

Beets may lower the risk of chronic disease

According to the experts, foods that are high in antioxidants— such as beets — have been shown to be beneficial in preventing disease.

Antioxidants help prevent disease by fighting free radicals, which are unstable molecules in your body that can damage cells.

Cellular damage caused by free radicals is called oxidative stress. This damage has been linked to a number of serious diseases, including heart disease and cancer.

According to one study, beets can contain up to 1.7 millimoles of antioxidants per 3.5 ounces. This includes a group of antioxidants called betalains, which are responsible for their reddish color.

They also contain other compounds that suppress infammation, which has also been linked to serious medical conditions.

Beets may lower the risk of diabetes complications

Diabetes can cause damage to your small blood vessels (microvascular damage) and your larger blood vessels (macrovascular damage). This may lead to complications that can affect your eyes, heart, kidneys, and other parts of your body.

One study suggests that antioxidants, such as those found in beets, reduce oxidative stress and free radicals in the body. Fewer free radicals in the body mean a lower risk of diabetes complications, which can include:

• retinopathy
• kidney disease
• neuropathy and diabetic foot disease
• cardiovascular disease

Beets may help reduce insulin resistance

A metabolite is a substance that remains after your body metabolizes, or breaks down, food or other material. There’s some evidence that one of the metabolites found in high concentrations in beets — called a nitrate — may reduce insulin resistance.

The same metabolite is found in human blood levels, but it is lower in people with insulin resistance, prediabetes, and cardiovascular risk factors than in people who don’t have a diabetes diagnosis.

According to a small 2017 study, participants with obesity who consumed a mixture of beet juice and carbohydrates showed lower insulin resistance than participants without obesity. This suggests that individuals with obesity may benefit from eating beets and other nitrate-rich foods.

An earlier 2014 study found that healthy participants who consumed beet juice during a meal had lower insulin and glucose responses following the meal. However, a very small 2013 study had different results. 27 individuals with type 2 diabetes who drank beetroot juice daily showed no improvement in insulin resistance.

These studies involved a small number of participants, and more research is needed. It’s possible that reduced insulin resistance may be one of the benefits of eating beetroot, which could potentially benefit individuals with diabetes.

Beets may help lower blood pressure

High blood pressure is a common complication in people with diabetes. Research suggests that eating beets or drinking beetroot juice might lower your blood pressure.

A 2013 study found that participants with hypertension who drank one cup of beetroot juice every day experienced a significant drop in blood pressure.Some participants also experienced an improvement in the elasticity of their blood vessels.

Researchers in the study suggested that nitrates in beet juice were responsible for the effects. They work by expanding blood vessels and improving blood flow.

This study also found that drinking beetroot juice was associated with reduced systolic blood pressure levels.Systolic blood pressure measures the pressure in your blood vessels when your heart beats.

More recently, a 2017 study found that nitrates in beetroot juice reduced central blood pressure in some people with type 2 diabetes. Central blood pressure is the pressure in your aorta — the large artery that sends blood away from your heart.

Are there any risks to eating beets if you have diabetes?

There are no known risks to eating beetroot if you have diabetes. The American Diabetes Association  encourages everyone to add more of these non-starchy vegetables to their diet.

Unless you’re allergic to beetroot, the only risk that comes with eating beets is beeturia. Beeturia is a condition that causes urine or stools to appear pink or red. A small number of people experience beeturia after consuming beetroot.

While it can be alarming, beeturia isn’t usually harmful. It’s caused by one of the compounds in beets that gives the vegetable its color, and it usually clears up on its own.

Ways to include beets in your diet

Beets are incredibly versatile and can be used to add color, flavor, and crunch to a number of dishes and beverages. You can use beets in salads, stews, casseroles, and smoothies.

Don’t forget to use the greens, which are packed with nutrients and eaten the same way you would eat spinach or kale. According to a source, one beet contains about 7 grams of carbohydrates.

Adding beetroot to your diet

Here are some ways to include beets in your diet:

• Cut slices or shave ribbons of raw beetroot and add to salads for extra color and crunch.
• Steam them with other vegetables for a delicious and healthy side dish.
• Roast beets in the oven. Then slice them up for a side dish, or add them to salads or omelets.
• Juice beets and experiment by combining them with other vegetables and fruits, like apples and carrots.

Buy fresh beetroot with the greens intact. Look for beets that are firm, smooth, and bright red-purple in color.

With the greens intact, you can store beetroot in the fridge for three or four days. Without the greens, beets can last in the fridge for two to four weeks.

The bottom line

Beets are rich in antioxidants and nutrients that have proven health benefits for everyone.

Consuming beets appears to be especially beneficial for people living with diabetes. Beets can help lower the risk of complications that may arise from an un-managed condition, including nerve damage and eye damage.

Beets are also versatile, delicious, and easy to include in all kinds of recipes.

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Maybe you’re just someone with blood in their urine’

A lady spent months battling a vicious stomach virus, followed by lingering nausea and pain that left her subsisting on a bland diet consisting largely of Cream of Wheat and applesauce. Her gut problems were accompanied by days of fatigue so extreme that at times she could barely drag herself up the stairs of her  home.

In October 2016, just as she was recovering, the 45-year-old sign-language interpreter and Grand Canyon river guide suddenly confronted a new and alarming symptom: visible blood in her urine.

For the next 13 months she underwent numerous tests conducted by specialists who were unable to determine what was causing the bleeding.

“Maybe you’re just someone with blood in their urine,” she remembers a urologist saying a year after the problem first appeared.

Less than a month after that October 2017 pronouncement, she learned the reason for the bleeding. A final diagnosis would take nearly three more months.

"It was really difficult to keep persevering,"she  said, whose ordeal was complicated by recurrent digestive problems and compounded by distance. Seeing specialists sometimes meant a five-hour round-trip drive from her home.

But the most frustrating part, she said who has worked in a medical clinic, was trying to convince skeptical doctors that her continuing symptoms seemed to indicate something serious. One flatly told her she was “too young” for the disease with which she was ultimately diagnosed.

Unexplained bleeding

In October 2016, she was preparing to lead a 16-day river trip when she noticed that her urine was tinged with pink.

“I thought, ‘That’s weird.’ I hadn’t eaten beets,” which could cause the temporary discoloration of urine known as beeturia, she  recalled. She had no pain or other symptoms and had never experienced chronic urinary tract infections, which can cause visible blood in the urine known as  gross hematuria.

A urinalysis performed the following day, after the bleeding was no longer visible, confirmed the presence of red blood cells and protein in her urine. Proteinuria can be caused by diabetes, high blood pressure or a family history of kidney disease, none of which applied to her. Her primary care physician ordered a CT scan of her abdomen and pelvis and referred her to a urologist.

The CT scan revealed the presence of two tiny, non-obstructing kidney stones, neither in a problematic location. The radiologist also noted atrophy on the upper portion of her left kidney, which he said “most likely represents a chronic injury.” The urologist performed a cystoscopy, a test that inspects the bladder; it was normal. The doctor suggested that she drink more fluids, which could help stave off a future kidney stone attack.

After the bleeding recurred, she consulted a second urologist, who sent her to a kidney specialist.

The nephrologist suggested that the intermittent bleeding might be caused by IgA nephropathy, a disease that damages the filters inside the kidneys and can occur after an illness.

The nephrologist advised continued monitoring of Hipsher’s kidneys, which were functioning normally. He was reluctant, for reasons Hipsher said he never articulated, to perform a kidney biopsy, which could definitively determine whether IgA nephropathy was the problem.

In May 2017, she decided she needed a new nephrologist. By now the bleeding was a daily occurrence.

The second nephrologist scheduled a needle biopsy for the following month. The test ruled out IgA nephropathy and failed to find anything that would explain the bleeding. Sometimes no cause can be found and the condition is labeled idiopathic hematuria.

She was not reassured; her urine was sometimes bright red. She decided she needed out-of-state expertise, so she called a prominent medical center and wangled an appointment. In July, she spent four days undergoing an extensive nephrology work-up.

Records describe her as “very healthy-appearing” and noted her “excellent outside” work-up. A pathologist reviewed the CT scan performed nine months earlier, but did not repeat it.

Doctors came to the same conclusion. They couldn’t find an explanation for her bleeding, nor did they uncover anything of concern.

When she asked the nephrologist if he could rule out cancer, she remembers he brushed it aside. The first kidney specialist had told her she was “too young” for kidney cancer.

'We're not going to worry'

For the next few months, she concentrated on her recurring and difficult to treat stomach problems, which were attributed to small intestinal bacterial overgrowth, a condition that can cause nausea, diarrhea and fatigue, and later a parasitic infection. The primary care doctor she had been seeing told her she was stumped and sent her to a family medicine specialist.

“She was referred to me because her case was confusing, and I do a lot of weird cases,” said Archie, whose practice combines conventional Western medicine and alternative practices, including the use of Chinese herbs and acupuncture.

In October, she returned to the second urologist to request a CT scan for the worsening bleeding, which included what appeared to be blood clots. The doctor, she said, balked.

“I wouldn’t radiate you again,” she remembers the specialist saying, adding “we’re not going to worry about” the blood.

When she persisted, the urologist agreed to consult a colleague to see if a CT scan was advisable.

Two weeks later, the urologist ordered the scan to check for an abnormal tangle of blood vessels known as an arteriovenous malformation, which can sometime cause bleeding.

The imaging test revealed something quite different: a grape-sized mass on her left kidney, in the same location where the atrophy had been noted 13 months earlier. The urologist, who referred her to a surgical oncologist , told her the 2.5 centimeter tumor might be benign.

She was certain it was not. The surgical oncologist agreed and told her it was probably malignant.

A week before Christmas, the surgeon removed the portion of Hipsher’s left kidney that contained the tumor, which he characterized as unlike anything he had seen.

Because of its unusual nature, pa­thol­ogy samples were sent to the Johns Hopkins Medical Laboratory  for analysis.

A few weeks later, in early January 2018, the  Dr. gave her the devastating news. She had a rare — and highly aggressive — disease called sarcomatoidrenal cell carcinoma.

Sarcomatoid cancer, which typically strikes men over 60, is characterized by poorly differentiated cells resembling a sarcoma, cancer that develops in tissue such as blood vessels or in bones. The percentage of differentiation reflects the tumor’s aggressiveness: the higher the percentage, the more aggressive the tumor.

Her tumor was 100 percent sarcomatoid. The average length of survival for sarcomatoid kidney cancer is about eight months.

Pathologists were unable to determine whether the cancer had originated in her kidney or in her bladder or ureter, the tube that carries urine from the kidney to the bladder. (Blood in the urine and fatigue are  common symptoms of kidney cancer.)

She was devastated — but not surprised.

“I’d known it was cancer deep down in my bones for a while,” she said. “I’m not sure how to explain it.” One of her aunts had been diagnosed with a rare sarcoma at age 53. Another died a month after being diagnosed with colon cancer. For the preceding two years, doctors had told her they couldn’t determine the reason for her double-digit weight loss and severe abdominal pain.

Archie said that doctors went back and examined her 2016 CT scan to see whether the tumor had been missed; he said no sign was found. “I think maybe the imaging was done at such an early stage that you can’t even see it,” he said.

Had she undergone a CT scan six months or so after the bleeding started, Archie said, the tumor might have been visible.

She regrets she didn’t push for a second CT scan sooner.

“What I definitely wish I had done was bring in pictures or a sample of bloody urine early on,” she said. “Somehow I think doctors believe patients when there is something visible or tangible, rather than just our words.”

Traveling for treatment

The pa­thol­ogy report from Hopkins did contain some good news: the tumor was small and appeared to be confined to her left kidney. Most sarcomatoid tumors are much larger and have metastasized widely when they are discovered. A PET scan showed no sign of disease.

CT scans performed three and six months after surgery, while she was undergoing complex tests for genetic mutations that could guide future treatment, were clean. And her lab tests were normal.

Because her cancer is rare, Archie suggested that she seek a consultation at the MD Anderson Cancer Center in Houston and helped arrange a visit.

In August 2018,she and her husband flew to Texas. She had received the standard first-line treatment — surgery — but the Houston oncologist told her that too much time had elapsed for chemotherapy or immunotherapy, sometimes used after surgery to prevent a recurrence.

“At this time we believe the risks of treatment outweigh the potential benefits,” one oncologist wrote.

A specialists recommended that she undergo active surveillance, which includes CT scans and lab tests every three months.

If her cancer recurs, doctors say they expect she would be treated with immunotherapy drugs that have shown promise in treating sarcomatoid tumors.

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She opted to receive treatment in Houston. So far, the news has been good: she remains cancer-free. Her next visit is scheduled for mid-August.

The couple live frugally and have what she characterizes as excellent health insurance. She is “stunningly grateful” to be able to afford the cost of travel and unreimbursed medical expenses, which last year totaled $21,000. “I really feel for the people for whom such a thing isn’t even an option,” she said.

Although she is still coming to terms with what has happened, she said she has largely succeeded in moving beyond the dismal statistics and feels generally optimistic. “It’s been hardest to watch what this has meant for my husband,” she said, adding that he has been her rock.

With the help of a therapist, she said she has found “a metaphor to live by: Live life like a river trip. You pack and plan and prepare the best you can. And even though you don’t know everything that will happen downstream, you launch.”