Beetroot / Dietary Nitrate
Beta vulgaris
Nitrate-rich juice that boosts nitric oxide for better exercise economy and modestly lower blood pressure.
Evidence tier
Moderate
Research weight
Citations
18 verified / 18
Classification
Performance
❝
What the evidence says. Several controlled trials; effects real but modest or context-dependent.
What is Beetroot / Dietary Nitrate?
Beetroot / Dietary Nitrate (Beta vulgaris) is a performance supplement used for improves submaximal exercise economy by lowering the oxygen cost of fixed-intensity work (~3-5% reduction in vo2 reported). NutriDex grades the human evidence as Moderate. Beetroot is one of the richest dietary sources of inorganic nitrate, which oral bacteria and the body convert via nitrite into nitric oxide, a signaling molecule that relaxes blood vessels and improves muscle efficiency. The most reproducible benefit is improved exercise economy: meta-analyses show nitrate lowers the oxygen cost of submaximal exercise and modestly extends time-to-exhaustion, with larger effects in open-ended endurance tasks than in fixed-distance time trials. In hypertensive adults, nitrate from beetroot juice produces small but meaningful reductions in systolic blood pressure (roughly 5 mmHg), though diastolic effects and benefits in normotensive or older adults are less consistent. Evidence for strength, power, and repeated-sprint performance is weaker and mixed. Overall the data are best described as moderate: real, mechanistically plausible effects of small-to-modest magnitude that depend on dose, timing, and population. The harmless red/pink urine (beeturia) some people notice is simply unabsorbed betalain pigment.
Purported Benefits
✓Improves submaximal exercise economy by lowering the oxygen cost of fixed-intensity work (~3-5% reduction in VO2 reported)
✓Modestly extends time-to-exhaustion / endurance, especially in open-ended aerobic tasks (pooled SMD ~0.33)
✓Produces small reductions in systolic blood pressure, most consistently in hypertensive adults (~5 mmHg clinic SBP)
✓May offer minor benefit to high-intensity intermittent and repeated-sprint performance, though effects are inconsistent
✓Boosts nitric oxide bioavailability, supporting vasodilation and blood flow
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Exercise economy (submaximal O2 cost)Meta-analyses show reduced submaximal O2 cost / improved economy, but VO2max is unchanged and effects are small. | Moderate | ↑ benefit · small | 2 |
| Endurance / time-to-exhaustionPooled SMD ~0.33 for time-to-exhaustion, mainly at >=6 mmol/day chronic dosing; no benefit for time-trial performance. | Moderate | ↑ benefit · small | 3 |
| Blood pressure (hypertensive adults)Pooled SBP drop ~5 mmHg in hypertensives (low-moderate certainty); isolated nitrate and older-adult trials often null. | Moderate | ↑ benefit · small | 4 |
| High-intensity / repeated-sprint performanceSmall, inconsistent effects across measures; benefit is task- and population-dependent, especially weak in women. | Mixed | ↔ mixed · negligible | 3 |
| Exercise recovery / muscle sorenessOne meta-analysis found faster strength/jump recovery and less soreness, but no change in CK or oxidative-stress markers. | Preliminary | ↑ benefit · moderate | 1 |
| Cardiovascular mortality (dietary nitrate)Only observational cohorts link vegetable nitrate to lower CVD mortality; confounded and attenuated by diet-quality adjustment. | Preliminary | ↑ benefit · moderate | 2 |
Dosing & Compounds
Typical Dose
~6-13 mmol (≈310-800 mg) inorganic nitrate per day, typically as 1-2 concentrated beetroot 'shots' (~70 mL each) or 250-500 mL juice; for acute performance, taken ~2-3 hours before exercise, or daily for 3+ days for fuller effect.
Active Compounds
Safety & Cautions
Generally well tolerated. The most common effect is harmless beeturia (red/pink urine) and occasionally reddish stool from betalain pigments. Because nitrate lowers blood pressure, use caution if taking antihypertensive drugs, PDE5 inhibitors (sildenafil/tadalafil), or nitrate medications, as additive effects may cause hypotension, dizziness, or fainting. Antibacterial mouthwash (e.g., chlorhexidine) and recent antibiotics can blunt the effect by killing the oral bacteria needed to reduce nitrate to nitrite. Beetroot is high in oxalate and potassium, so people prone to calcium-oxalate kidney stones or with chronic kidney disease (hyperkalemia risk) should limit intake. Theoretical concern exists about nitrate/nitrite and N-nitroso compounds, but dietary/vegetable nitrate is not associated with the risks linked to processed-meat nitrites. Safety data in pregnancy, breastfeeding, and infants are limited, so supplemental doses are best avoided in these groups. Whole food beet intake is safe for most people; consult a clinician before using high-dose nitrate shots if you have low blood pressure, kidney disease, or are on relevant medications. Educational only — always check with your doctor or pharmacist before combining Beetroot / Dietary Nitrate with any medicine.
Beetroot / Dietary Nitrate drug interactions
Known or theoretical interactions between Beetroot / Dietary Nitrate and common medications — educational, not exhaustive. Always check with your doctor or pharmacist before combining Beetroot / Dietary Nitrate with any medicine.
Monitor
Blood-pressure drugs
Dietary nitrate may add to BP-lowering drugs, risking mild hypotension.
Beetroot nitrate becomes nitric oxide, causing vasodilation additive with antihypertensives. Siervo — Nitrate/beetroot & blood pressure (meta-analysis)
Key Studies ★ 18 studies
Systematic review
Nutrients Umbrella 2025
✓ PubMed
Umbrella review of 15 meta-analyses found beetroot juice produced only negligible-to-small gains: VO2max SMD 0.16 (p=0.033) and time-to-exhaustion SMD 0.25 (p=0.034) in healthy adults, with non-athletes showing larger aerobic gains (SMD 0.26) than athletes.
Systematic review
Poon 2025
✓ Full text
Umbrella review of 20 meta-analyses (180 studies, 2,672 participants) found mixed ergogenic effects; dietary nitrate improved time-to-exhaustion (SMD 0.33; 95% CI 0.19-0.47), most with >=6 mmol/day and chronic (>3 day) dosing.
Meta-analysis
Gronroos 2024
✓ PubMed
Meta-analysis of 11 RCTs (349 hypertensive patients) found beetroot juice reduced clinical systolic BP by -5.31 mmHg (95% CI -7.46, -3.16), with no significant effect on diastolic or 24-h BP; certainty of evidence low.
Meta-analysis
Nutrition Research 2025
✓ PubMed
Meta-analysis of 6 RCTs (181 adults) of chronic isolated nitrate supplementation (250-590 mg/d, >=1 week) found no significant reduction in systolic BP, diastolic BP, or resting heart rate, isolating nitrate from whole beetroot effects.
Meta-analysis
Nutrition Journal 2025
✓ Full text
GRADE-assessed dose-response meta-analysis of RCTs on plasma/dietary nitrate found beneficial effects on blood pressure and vascular health biomarkers, with dose-response relationships characterized across trials.
Meta-analysis
Jones 2021
✓ PubMed
Systematic review/meta-analysis of human trials: nitrate-rich beetroot juice accelerated isometric strength recovery at 72 h post-exercise (SMD 0.54) and countermovement-jump recovery at 24-72 h (SMD 0.75-1.32), and raised pressure-pain threshold (less soreness); no effect on creatine kinase or oxidative stress.
Meta-analysis
Siervo 2013
✓ PubMed
Meta-analysis of 16 RCTs (254 adults): inorganic nitrate/beetroot juice reduced systolic BP by 4.4 mmHg (95% CI -5.9 to -2.8; P<0.001), with a smaller, non-significant diastolic effect (-1.1 mmHg); dose-response relationship between daily nitrate dose and systolic BP reduction.
Umbrella review of meta-analyses
20 systematic reviews/meta-analyses
✓ PubMed
An umbrella review found nitrate supplementation significantly improved time-to-exhaustion (SMD 0.33, 95% CI 0.19-0.47), particularly at ≥6 mmol/day and with chronic dosing, but had no significant effect on time-trial performance (SMD -0.03).
Systematic review and meta-analysis
73 RCTs, n=1061
✓ PubMed
Meta-analysis in healthy adults found dietary nitrate increased time-to-exhaustion (+25.3 s) and power output (+4.6 W) and reduced submaximal oxygen consumption (-0.04 L/min), with no change in VO2max, indicating improved exercise economy.
Systematic review and meta-analysis
7 RCTs, n=218
✓ PubMed
In patients with arterial hypertension, nitrate from beetroot juice reduced systolic blood pressure by a pooled 4.95 mmHg (95% CI -8.88 to -1.01; moderate-certainty evidence) but did not significantly lower diastolic BP.
Systematic review and meta-analysis of RCTs
Meta-analysis of RCTs
✓ Source
Nitrate supplementation had small positive effects on selected outcomes during single and repeated bouts of short-duration high-intensity exercise (e.g., mean power and intermittent-test distance), but effects were inconsistent across measures.
Systematic review and meta-analysis
Systematic review and meta-analysis
✓ Full text
In females specifically, nitrate supplementation showed limited and inconsistent benefit for muscle strength, power, and sprint performance, underscoring that ergogenic effects are population- and task-dependent.
RCT
JISSN Women HIIE 2024
✓ PubMed
Double-blind crossover RCT (n=13 women) testing 6.45 vs 12.9 mmol nitrate found beetroot juice lowered mean heart rate and perceived exertion versus placebo during high-intensity interval exercise, with no added benefit from the higher dose.
RCT
medRxiv/PMC 2025
✓ Full text
Replicate double-blind placebo-controlled crossover RCT found nitrate-rich beetroot juice lowered systolic BP by -7 mmHg (95% CI -3 to -11) and diastolic by -6 mmHg (95% CI -2 to -9), but with large inter-individual response variability (+/- 7 mmHg).
RCT
Stanaway/Food & Function 2024
✓ Full text
4-week RCT crossover in 15 older adults (56-71 y) with treated hypertension found daily beetroot juice altered nitrate metabolism but did not improve vascular function or blood pressure.
RCT
Kapil 2014 (BHF phase 2 RCT)
✓ PubMed
In 68 hypertensive patients, 4 weeks of daily nitrate-rich beetroot juice (250 mL, ~6.4 mmol nitrate/day) lowered clinic BP by 7.7/2.4 mmHg, 24-h ambulatory BP by 7.7/5.2 mmHg, and home BP by 8.1/3.8 mmHg vs nitrate-depleted placebo, with ~20% improvement in endothelial function and reduced arterial stiffness; no tachyphylaxis.
Cohort
Liu 2018 (Blue Mountains Eye Study)
✓ PubMed
Prospective cohort of 2229 older Australians over 14 years: higher vegetable-derived nitrate intake was inversely associated with CVD mortality; quartiles 2-4 (>=69.5 mg/day) had ~37-49% lower CVD mortality vs lowest quartile (e.g., Q3 HR 0.51, 95% CI 0.32-0.80), independent of CVD risk factors.
Cohort
Blekkenhorst 2017
✓ PubMed
Prospective cohort of 1226 older women over 15 years: each SD higher vegetable nitrate intake was associated with 21% lower atherosclerotic vascular disease mortality (multivariable HR 0.79, 95% CI 0.68-0.93) and 13% lower all-cause mortality (HR 0.87), though attenuated after diet-quality adjustment.