Does Beetroot Lower Cholesterol?

The most comprehensive review of clinical trials to date found that beetroot consumption has no significant effect on total cholesterol, LDL, HDL, or triglycerides. A 2021 meta-analysis pooling results from randomized controlled trials concluded that beetroot “cannot be categorized as an effective supplementation for adjustment of lipid profile.” That said, a handful of smaller studies have found intriguing effects in specific populations, and the story gets more interesting when you look beyond standard cholesterol numbers to things like fatty acid ratios and liver fat.

What the Largest Review Actually Found

The strongest piece of evidence on this question is a systematic review and meta-analysis that searched four major databases for randomized controlled trials of beetroot and blood lipids, published through December 2020. The pooled results showed no meaningful shift in any lipid marker. Total cholesterol, triglycerides, HDL (“good” cholesterol), and LDL (“bad” cholesterol) all stayed essentially flat compared to placebo groups. The researchers also split the data by health status of participants, the form of beetroot used (juice, powder, extract), and type of intervention. None of these subgroups showed a significant effect either.¹

This is about as clear a negative result as nutrition science produces. When a meta-analysis pools multiple trials and still finds nothing, even in subgroups, it is strong evidence that the effect either does not exist in the general population or is too small to detect reliably. If your primary goal is bringing down your cholesterol numbers, beetroot alone is unlikely to do it.

The Exceptions That Keep Researchers Interested

That meta-analysis tells the average-population story. But a few individual studies have found effects in narrower groups, and they are worth understanding because they point to when beetroot might matter more.

One pilot study looked specifically at people with uncontrolled high blood pressure, meaning their blood pressure remained elevated despite being on medication. In that group, drinking nitrate-rich beetroot juice led to a drop in LDL cholesterol of about 0.36 mmol/L, which reached statistical significance. The same study found no change in people whose blood pressure was already well controlled with medication.² That is a meaningful distinction. It suggests that the metabolic environment of uncontrolled hypertension, which involves higher levels of oxidative stress and vascular dysfunction, may make a person more responsive to the nitrate and antioxidant compounds in beetroot.

Another small pilot study found that seven days of beetroot powder consumption lowered total cholesterol by about 10 percent, and that this drop was correlated with how much nitric oxide levels rose in each participant’s blood.³ A 10 percent reduction sounds impressive, but pilot studies are very small, typically fewer than 20 participants, with no control group to rule out normal fluctuation. These are the kinds of findings that generate hypotheses for larger trials rather than conclusions you should act on.

The pattern across these smaller studies is consistent: when researchers look at healthier or more general populations, beetroot barely moves the cholesterol needle. When they look at people with existing cardiovascular problems or metabolic stress, there are occasional hints of benefit. This is a common pattern in nutrition research, and it makes biological sense. A food compound that acts through antioxidant or anti-inflammatory pathways may have little to fix in someone whose system is already running smoothly.

How Beetroot Could Plausibly Affect Lipids

Even though the clinical results are underwhelming, beetroot is not biochemically inert. It contains several compounds that, at least in theory, could influence cholesterol and fat metabolism.

The most studied is inorganic nitrate. Your body converts the nitrate in beetroot into nitric oxide, a signaling molecule that relaxes blood vessels and lowers blood pressure. This is well established and is the reason beetroot juice has become popular among athletes and people managing hypertension. The link to cholesterol is less direct: nitric oxide influences how the endothelium (the lining of blood vessels) handles fat particles, and some researchers think improved endothelial function could change how lipids are processed over time. The pilot study mentioned above, which found a correlation between rising nitric oxide and falling cholesterol, lends a thread of support to this idea, though it is far from proof.³

Beetroot also contains betalains, the pigments responsible for its deep red color, which have antioxidant properties. And it contains small amounts of phytosterols, plant compounds structurally similar to cholesterol that can reduce cholesterol absorption in the gut and influence how the liver handles cholesterol.⁴ The concentrations of phytosterols in a typical serving of beetroot are modest compared to what you would get from a dedicated phytosterol supplement, however, which helps explain why the cholesterol-lowering effect does not show up reliably in trials.

Raw beetroot is also a decent source of dietary fiber, roughly two to three grams per cup, and soluble fiber has a well-established mechanism for binding bile acids and pulling cholesterol out of circulation. Research on pectin, a type of soluble fiber present in beets, has confirmed it can bind certain bile salts.⁵ But again, the fiber content of a glass of beetroot juice or a supplement capsule is lower than what you would get from eating a bowl of oats or beans, which makes it hard for beetroot to compete on fiber grounds alone.

Beyond Cholesterol Numbers

One limitation of asking “does beetroot lower cholesterol?” is that the question focuses on a single lab value. Some of the more interesting findings in recent studies involve markers that a standard lipid panel does not capture.

A randomized controlled trial in patients with chronic coronary artery disease found that four weeks of beetroot extract supplementation shifted the ratio of saturated to polyunsaturated fatty acids in the blood. The ratio dropped, which is considered favorable because a lower ratio suggests less atherogenic (artery-clogging) potential. When beetroot was combined with vitamin C, the changes were more pronounced: omega-3 fatty acids increased, the ratio of saturated to polyunsaturated fats fell further, and markers of oxidative stress dropped significantly.⁶

Why does this matter if the total cholesterol number does not move? Because cardiovascular risk is not determined by one number. Research across large cohorts has shown that the number of atherogenic particles in the blood, measured by apolipoprotein B (apoB), is a robust predictor of heart disease independent of LDL cholesterol levels.⁷ A food that shifts fatty acid composition, reduces oxidative stress, and improves the character of circulating lipids could conceivably reduce cardiovascular risk without ever changing the total cholesterol number your doctor reads from a lab report. This is speculative territory, and no trial has yet shown that beetroot reduces heart attacks or strokes. But it does suggest that dismissing beetroot’s cardiovascular relevance based solely on standard lipid panels may be premature.

Acute Effects After a Fatty Meal

A separate line of research has looked at what happens to your lipids in the hours right after a high-fat meal, not over weeks or months. Your body handles a spike in dietary fat through a complex postprandial process, and how well you clear those fats from the blood can matter for long-term cardiovascular health.

A trial in patients with dyslipidemia found that drinking beet leaf and stalk juice alongside a high-fat meal prevented the usual drop in HDL cholesterol that occurs after such a meal. The high-fat meal spiked triglycerides and reduced HDL, as expected, but the HDL reduction was blunted in both groups that received beet juice.⁸ Protecting HDL from dropping after a fatty meal is a modest benefit, but it is biologically plausible: polyphenols in beet greens may buffer the oxidative stress that dietary fat triggers.

A crossover trial in middle-aged and older adults with overweight, however, found no significant differences in triglycerides, glucose, or insulin after four weeks of daily beetroot juice, even when testing after a high-fat meal.⁹ The discrepancy between these two studies likely reflects the different populations studied and the different parts of the beet plant used. The first used beet leaves and stalks, which are richer in certain polyphenols than the root, in patients who already had abnormal lipid levels. The second used root juice in people selected for overweight alone. Once again, the pattern holds: effects appear mainly in people whose metabolism is already stressed.

Beetroot and Liver Fat

The liver is the body’s cholesterol factory, producing far more cholesterol than you ever eat. So anything that improves liver function could, at least in principle, influence how your body manages cholesterol over the long haul. Beetroot has shown genuine promise here, independent of its direct effects on lipid panels.

In animal models of type 2 diabetes, beetroot extract significantly reduced hepatic lipid accumulation, meaning less fat stored inside the liver. The treated animals also showed lower serum cholesterol, triglycerides, and LDL, along with improved insulin sensitivity.¹⁰ Animal results do not translate directly to humans, but the mechanism makes sense: betalains and other antioxidants in beetroot appear to activate pathways (specifically a receptor called PPARα) that help the liver burn fat rather than store it.

A human trial moved closer to confirming this connection. Patients with non-alcoholic fatty liver disease (NAFLD) who drank beetroot juice showed a significant reduction in hepatic steatosis (liver fat) compared to controls. When the beetroot juice was combined with a Mediterranean diet, the improvement was even greater.¹¹ NAFLD affects roughly a quarter of the global adult population and is a strong risk factor for both cardiovascular disease and type 2 diabetes. The fact that beetroot juice reduced liver fat does not directly mean it lowered circulating cholesterol in those patients, but reducing liver fat improves the metabolic machinery that governs cholesterol production and clearance. For someone with fatty liver, this might be where beetroot provides its most meaningful contribution to cardiovascular health.

Gut Microbiome Effects

An emerging area of research sits even further from the standard cholesterol question but is worth mentioning for context. A pilot study in weaned pigs found that adding red beetroot to the diet enhanced gut microbial pathways involved in lipid metabolism, including those governing fatty acid breakdown and phospholipid handling.¹² This is an animal study and a pilot at that, so it tells us almost nothing about what will happen in your gut. But it is consistent with a growing body of work suggesting that the polyphenols and fiber in colorful vegetables shape the microbial communities that influence lipid absorption and bile acid recycling. If future human trials confirm similar microbiome shifts, it would provide a plausible indirect route for beetroot to affect long-term cholesterol dynamics, even if the acute effect on a blood test remains small.

Why the Gap Between Animal and Human Results

If you have ever searched this topic, you have probably encountered dramatic-sounding claims about beetroot slashing cholesterol. Many of those claims trace back to animal studies, where researchers can use concentrated extracts at much higher doses, control every variable in the animal’s diet, and study animals that have been bred or induced to have metabolic disease. In the diabetic rat study, for example, the dose of beetroot extract was given relative to body weight at a concentration you could not realistically replicate by eating beets or drinking juice.

Human trials are messier. People vary in their baseline cholesterol, their diets, their genetics, their medications. A modest effect that shows up clearly in a controlled rat study can easily vanish into the noise of a human trial with 30 or 40 participants. This does not mean the biology is fake; it means the effect size in real-world humans, eating normal amounts of beetroot alongside variable diets, is probably small enough that it takes a very large or very targeted trial to detect it. The meta-analysis pooling several such trials found nothing, which sets a clear boundary on how large the average-population effect could be.

Controlled Versus Uncontrolled Blood Pressure

The most clinically interesting finding from the human evidence is the contrast between people whose blood pressure is well managed and those whose blood pressure remains high despite treatment. The pilot study that found a drop in LDL among uncontrolled hypertensives found essentially nothing in controlled hypertensives.² One interpretation is that people on effective blood pressure medication already have improved endothelial function and reduced oxidative stress, leaving less room for beetroot’s nitrate-derived nitric oxide to add benefit. Another interpretation, less flattering to beetroot, is that the finding in uncontrolled hypertensives is a statistical fluke in a small sample. Until a larger trial replicates it, both interpretations remain on the table.

If you are in the category of uncontrolled hypertension, beetroot juice is not a substitute for talking with your doctor about medication adjustments. But it is reasonable to consider it a dietary addition that has some evidence, however preliminary, of synergizing with cardiovascular management in that specific context. For everyone else, the evidence for cholesterol-lowering is simply too thin to rely on.

What Practical Sense to Make of All This

Beetroot is a nutritious vegetable. It delivers nitrate, fiber, folate, potassium, and antioxidants. If you enjoy it, it fits well into a heart-healthy diet. But if your doctor has flagged your cholesterol and you are hoping to avoid medication by drinking beet juice, the evidence does not support that strategy. The meta-analysis is clear: across multiple trials, in various populations, using various forms of beetroot, cholesterol markers do not budge in a reliable or clinically meaningful way.¹

Where beetroot may earn its keep cardiovascularly is in blood pressure reduction, which has much stronger trial support than anything related to lipids. It may also be useful as part of a broader dietary pattern for people with fatty liver disease, where its combination with a Mediterranean diet showed genuinely encouraging results in a randomized trial.¹¹ And for people already managing coronary artery disease, the shifts in fatty acid profiles and oxidative stress markers are worth watching as the research matures.⁶

Beetroot Juice Versus Whole Beets Versus Supplements

People often wonder whether the form of beetroot matters. Commercially available beetroot juice, usually “shots” of concentrated juice, is the most studied form because it allows researchers to standardize the nitrate dose. Beetroot powder in capsules has also been tested. Whole roasted or boiled beets are the least studied in clinical trials but arguably the most nutritious option because you get the full fiber content, which juice strips away.

Even in the meta-analysis, breaking results down by form of consumption (juice, extract, or whole beet) did not reveal a hidden benefit for any particular preparation. One caveat: cooking beetroot at high temperatures degrades betalains, the pigments with antioxidant activity. Steaming or roasting at moderate heat preserves more of these compounds than boiling, which leaches them into the cooking water. If you are eating beets for their bioactive compounds rather than just their macronutrients, cooking method matters at least a little. For nitrate content, though, the differences between cooking methods are smaller, and even canned beets retain a reasonable amount.

Beetroot supplements marketed for “cardiovascular health” or “cholesterol support” typically emphasize nitrate content. Be aware that supplement labels may list beetroot as an ingredient without guaranteeing a specific nitrate dose, and the nitrate content of beet products varies depending on growing conditions and processing. If blood pressure reduction via nitrate is your goal, products that list a standardized nitrate content are more reliable. If cholesterol reduction is your goal, no form of beetroot currently has strong enough evidence to justify a supplement purchase for that reason alone.