Betalains are the red and yellow pigments of beetroot, prickly pear, chard and red dragon fruit. Human evidence is modest and specific: small, consistent endurance and recovery gains in trained adults, and better blood-vessel and cholesterol markers in people with existing heart disease. Everything broader rests on cells, worms and rodents. Harmless red urine is the main documented effect. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Low-density lipoprotein cholesterol (LDL-C) | <100 mg/dL; <70 mg/dL with vascular disease | Changed meaningfully in the only lipid trial |
| Non-high-density lipoprotein cholesterol | <130 mg/dL; <100 mg/dL with vascular disease | Captures every artery-damaging particle |
| Homocysteine | 5–8 µmol/L | Most responsive marker in the coronary trial |
| Fasting glucose | 75–90 mg/dL | Tests the glycemic claim directly |
| Glycated hemoglobin (HbA1c) | 4.8–5.3% | Integrates three months of glucose exposure |
| Seated blood pressure | 110–120 / 70–78 mmHg | Detects both the benefit and the additive hypotension risk |
| High-sensitivity C-reactive protein (hs-CRP) | <1.0 mg/L | Tests the anti-inflammatory claim |
| Urinalysis with microscopy if positive | No blood, no protein | Establishes that red urine is pigment, not bleeding |
| Serum ferritin and transferrin saturation | Ferritin 50–150 ng/mL; saturation 25–35% | Beeturia frequency tracks iron status |
| 24-hour urinary oxalate | <25 mg/24 h | Only for heavy beet-green or chard intake |
| Estimated glomerular filtration rate (eGFR) with creatinine | eGFR >90 mL/min/1.73 m² | Context for tolerating an oxalate load |
Cadence: Blood pressure at 2 and 4 weeks; the lipid, homocysteine and glucose panel at 8–12 weeks; then every 6–12 months while intake continues. A 24-hour urinary oxalate measurement is added at 12 weeks with large amounts of beet greens or chard.