Beetroot and Dietary Nitrate

We evaluated 172 human studies on Beetroot and Dietary Nitrate, including 141 randomised controlled trials and 21 meta-analyses or systematic reviews; the controlled studies include 4,342 participants in total. As of 13 October 2026.

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1. What Is Beetroot and Dietary Nitrate? Occurrence, Origin and Forms

Beetroot is the root of Beta vulgaris, a species in the amaranth family (Amaranthaceae). It naturally contains nitrate, which the body can convert via nitrite into nitric oxide. It is eaten as a vegetable and drunk as a juice, and it is studied where vascular function and physical exercise are measured.

Beetroot is grown as a crop in temperate climates and used as a vegetable, juice or powder. Nitrate also occurs in many other leaf and root vegetables.

Juice is pressed from the root, reduced to a concentrate or dried into a powder, and the cooked or raw root is eaten as well. Studies mostly examine juice and concentrate, alongside capsules and powder and nitrate salts, which allow the effect of nitrate alone to be examined.

Forms and Preparations Studied

• Beetroot juice
• Beetroot concentrate (shot)
• Beetroot powder
• Capsules with beetroot extract
• Nitrate salts (sodium nitrate, potassium nitrate)
• Cooked or raw beetroot as food

Not covered on this page:

• Organic nitrates used as medicines (for example glycerol trinitrate) release nitric oxide directly and are not the nitrate from food.
• Nitrite curing salt in meat products belongs to preservation and not to the beetroot topic.
• Studies on other nitrate-rich vegetables (for example spinach, rocket) are not studies on beetroot.
• Betaine and betanin are further constituents of the root and are studied separately from nitrate.

2. What Does Beetroot and Dietary Nitrate Do? Results by Area

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

Beetroot and Dietary Nitrate, Exercise Performance and Endurance: Human Studies

Compared with placebo, beetroot juice and nitrate-rich beetroot extract increased muscle strength in two controlled studies 5568. In a further one, the rate of force development increased, but not maximal strength 77. Muscle endurance, measured as repetitions or hold time to exhaustion, was higher in several controlled studies with beetroot juice or beetroot powder than on placebo 7693109120. Peak performance was above placebo or control after beetroot juice in several controlled studies, sometimes only briefly 7081103. Two meta-analyses found better exercise capacity with nitrate compared with placebo, in COPD and in young healthy men 821. In women, in well-trained endurance athletes and in crossover studies in COPD, by contrast, no confirmed advantage was shown 821. Concentrated beetroot juice prolonged the strength endurance of the leg extensors only in men 87. The walking distance was longer in COPD and in postmenopausal women in several controlled studies than on placebo or training alone 2564101150. In Long COVID, diabetes and in individual COPD studies, several controlled studies found no difference from placebo in walking distance and exercise endurance 845144105. Sprint and jump performance also remained unchanged in sprinters and female athletes 118100. The findings apply only to the form and preparation studied in each case, since juice, concentrate, powder, capsules and nitrate salts are not interchangeable. A systematic review found the performance effect with beetroot juice and a nitrate-rich diet, but not with nitrate salts 3. In older people in training, beetroot extract did not change strength and endurance compared with placebo 40. It remains open which form, nitrate amount and duration of intake are beneficial for which population group and type of exertion.

Further studies in this area: 21 25 31 37 40 43 44 51 52 55 58 64 66 68 69 70 72 73 74 75 76 77 78 80 81 82 83 84 86 87 88 92 93 95 100 101 103 104 105 106 109 112 113 114 115 116 118 119 120 121 122 127 128 129 130 131 132 133 134 135 136 138 139 140 141 142 143 145 147 150 152 154 155 156 159 161 162 163 164 166

Beetroot and Dietary Nitrate and Blood Pressure: Human Studies

Compared with low-nitrate placebo juice, nitrate-rich beetroot juice lowered systolic blood pressure in several controlled studies, in hypertension and in COPD also over weeks 3625150. Diastolic blood pressure also fell more than with placebo in hypertension, in healthy men and in COPD 369773; in a further COPD study it fell only compared with baseline 105. Two meta-analyses found a reduction in both values, one of them depending on the nitrate amount 28; a meta-analysis on sodium nitrate alone, by contrast, found no confirmed reduction 16. In treated or incipient hypertension, however, beetroot juice did not lower long-term blood pressure in two controlled studies 5633. Resting blood pressure also remained unchanged in several controlled studies with beetroot juice or sodium nitrate 7091117154. Tablets made from beetroot extract, potassium nitrate, thiamine nitrate, vitamin C and plant extracts lowered blood pressure more than placebo; the finding applies to this mixture, not to beetroot alone 38. The strength of evidence is high, but the majority of controlled individual studies found no difference, and most studies were small and short; it remains open whether the effect is confirmed with longer use and in already treated patients.

Further studies in this area: 19 22 24 25 26 27 28 29 33 36 39 41 47 49 50 53 56 60 62 65 70 73 79 83 84 85 88 89 91 94 97 99 105 107 110 111 112 117 122 123 125 126 129 133 140 142 143 146 148 150 152 153 154 156 157 158 160 161 165

Beetroot and Dietary Nitrate, Vascular Function and Endothelium: Human Studies

For vascular function and endothelium, a mixed picture emerges: several controlled studies found improved flow-mediated dilation after nitrate-rich beetroot juice 3563748283, and the meta-analysis on nitrate salts and nitrate-rich foods also reports an improvement in this parameter 2. Microvascular perfusion improved more with beetroot juice in addition to calorie restriction than with calorie restriction alone 53; in two further studies it increased only within the juice group 4148, and others found no difference 126146152. For endothelial function, two controlled studies found an improvement compared with placebo or calorie restriction alone 3653, while others showed no difference here 6062117. Arterial stiffness decreased in hypertension with nitrate-rich juice 36, and nitrate-rich beetroot powder abolished the caffeine-induced increase in vascular stiffness 62. Investigated were predominantly beetroot juice, as well as concentrate, powder, extract capsules and nitrate salts, mostly against nitrate-poor placebos. A meta-analysis that evaluated nitrate salts and beetroot preparations together also found better vascular function, weaker in older people 13. The strength of evidence is high, but the differences in form, nitrate amount, comparison and population leave open for which preparation and which population group the benefit applies.

Further studies in this area: 36 39 41 48 49 50 51 53 60 62 63 74 82 83 88 90 91 94 99 102 104 107 108 110 111 112 117 120 122 125 126 132 134 137 140 144 146 148 150 151 152 153 154 160 165

Beetroot and Dietary Nitrate, Oxygen Supply and Muscle Efficiency: Human Studies

Compared with placebo or training alone, nitrate-rich beetroot juice increased maximal oxygen uptake in several controlled studies, in mountaineers, rowers, older women and in heart failure 5564138145. Oxygen consumption at the same submaximal exertion was lower in several controlled studies with beetroot juice or nitrate than on placebo, sometimes only after longer exertion 73128130154. In female endurance athletes, maximal oxygen uptake increased after beetroot concentrate only within the juice group; the study does not report a group comparison 86. Muscle oxygen saturation during strength training was higher in two controlled studies with beetroot powder or beetroot juice than on placebo 120132. Exhaled nitric oxide was increased in several controlled studies with beetroot juice and beetroot concentrate 104131143. Maximal oxygen uptake, by contrast, remained unchanged in heart failure with preserved ejection fraction on potassium nitrate 31129 and in cancer survivors 154. Oxygen consumption under submaximal exertion also did not differ from placebo in several controlled studies, for instance in diabetes, COPD and female athletes 44105127. Investigated were mainly beetroot juice, concentrate (shot) and powder, more rarely capsules or nitrate salts. What remains open is the transferability to patient groups, the influence of accompanying circumstances such as mouth rinsing and training status, and the question of which form and nitrate amount are decisive for an effect.

Further studies in this area: 73 86 88 104 105 116 120 121 124 127 128 130 131 132 138 141 143 145 147 152 154 156 162

Beetroot and Dietary Nitrate, Oral Bacteria and Nitrate Metabolism: Human Studies

Salivary nitrate and salivary nitrite rose significantly more with nitrate-rich beetroot juice than with placebo in several controlled studies 5669112118. In people with elevated cholesterol, the composition of salivary bacteria changed with nitrate-rich juice, and Neisseria flavescens increased compared with placebo 35. A systematic review found that after nitrate administration, mostly as beetroot juice, there were more Neisseria and Rothia, a higher salivary pH and less gum inflammation 11. As a mouth rinse for gum inflammation, plaque and gums improved with beetroot juice as well as with chlorhexidine; Streptococcus bacteria decreased more persistently with chlorhexidine 45. In female athletes, a single dose did not change the composition of the oral flora 100. Mostly beetroot juice and a beetroot concentrate were studied, sometimes as a mouth rinse. According to a systematic review, measures that harm oral bacteria weaken the performance effect of nitrate 3. The strength of evidence is high, but most studies are small and short, and the transferability to powder, capsules or the cooked beet is open.

Further studies in this area: 112 118 123 165

Beetroot and Dietary Nitrate, Cerebral Blood Flow and Cognitive Performance: Human Studies

Beetroot extract as a chewable tablet improved verbal memory, frontal brain functions and cognitive flexibility in a controlled study compared with placebo, but not working memory 46. Beetroot juice in addition to calorie restriction improved cognitive flexibility more than calorie restriction alone 53. In diabetes, nitrate-rich juice shortened only simple reaction time, while other tests remained unchanged 57. Sodium nitrate increased cerebrovascular CO2 reactivity compared with placebo in a controlled study, but only in men 91. In metabolic syndrome, beetroot juice did not change cerebral autoregulation and cognition in the main analysis; only exploratory analyses showed improvements in individual frontal brain areas 67. A randomized controlled study on fermented red cabbage with beetroot as a mixture found better attention and better working memory, but does not allow conclusions about beetroot alone 149. The findings apply to the respective form studied — juice, extract chewable tablets, nitrate salt or fermented vegetable — and, because of small participant numbers and short duration, are only moderately robust; it remains open whether the effects persist with larger groups and longer intake.

Beetroot and Dietary Nitrate: Further Outcomes in Studies

Several controlled studies and a meta-analysis showed that beetroot juice, beetroot extract and sodium nitrate increased plasma nitrate levels 244677791. Plasma nitrite levels also rose in several controlled studies 17446277101. Urinary nitrate excretion was increased in several controlled studies 23245660. For blood lactate 47113116119134, heart rate 71637110 and muscle contraction 7793113118127, several controlled studies and meta-analyses found no difference. The strength of evidence is overall high, but many studies are small and short, and the comparison conditions (placebo, low-nitrate juice, nitrate salt) differ.

Further studies in this area: 32 34 37 39 40 42 46 47 49 51 53 55 59 62 69 70 71 77 78 85 93 96 98 103 104 109 110 111 113 116 117 118 119 121 127 129 132 134 138 146 148 155 156 161 166 167

4. How Is Beetroot and Dietary Nitrate Dosed? Preparation, Dose and Duration in Studies

The studies used predominantly beetroot juice, as well as beetroot concentrate (shot), beetroot powder, capsules with beetroot extract, nitrate salts and cooked or raw beetroot as a food. The doses and nitrate amounts are listed in the table. Juice, concentrate, powder, capsules and nitrate salts are not interchangeable, and the findings apply in each case only to the form and preparation studied.

5. Is Beetroot and Dietary Nitrate Safe? Side Effects in Studies

The studies report predominantly good tolerability; in several controlled studies no serious adverse events or side effects occurred 2531353667. In a randomized study with pregnant women with chronic kidney disease, fewer women had serious adverse events on beetroot juice than on standard care 26. In COPD, one participant experienced a drop in blood pressure on standing with symptoms after beetroot juice 84; on potassium nitrate, no clinically significant hypotension and no methemoglobinemia occurred in heart failure 129. Details on side effects and laboratory values are shown in the table.

6. What Remains Open: Limits of the Evidence

• It remains open which form, nitrate amount and duration of intake are beneficial for which population group and type of exertion.
• Most studies were small and short; the transferability to larger groups and longer use is unclear.
• The comparison conditions (placebo, nitrate-poor juice, nitrate salt) differ, which makes it difficult to classify the effects.
• With mixed preparations containing additional substances such as nitrate salts, caffeine, l-arginine, nitrite, vitamin C or inulin, the effect cannot be attributed to beetroot alone.
• The transferability of the findings to powder, capsules or cooked beetroot is open, since most studies investigated juice or concentrate.

7. Bottom Line: What Is Established About Beetroot and Dietary Nitrate

In controlled studies, beetroot and preparations made from it reliably increase the plasma and salivary levels of nitrate and nitrite and thereby support the nitrate–nitrite pathway. For physical exertion, blood pressure, vascular function and oxygen supply, several controlled studies show improvements compared with placebo, but numerous results with no difference stand against these. The strength of evidence is high for several areas, but the results remain mixed because form, nitrate amount, comparison and population vary widely. Tolerability was predominantly good in the studies; serious adverse effects were rarely reported.