Beetroot and Dietary Nitrate: What the Evidence Shows for Blood Pressure and Exercise

Beetroot is a vegetable first and a supplement second, and almost everything it does traces back to one compound: dietary nitrate. This guide covers the trials that matter, the doses they used, and where the evidence is strong or weak. The short version: nitrate works through a pathway that starts in your mouth, the trials used 200 to 800 mg of nitrate per day, and the strongest evidence is for endurance capacity, with a smaller and less certain effect on blood pressure support.

What Dietary Nitrate Is and How Your Body Uses It

Dietary nitrate is a naturally occurring compound found in several vegetables, and beets are among the richest sources. It is the raw material for a chain of reactions that ends in nitric oxide, a signaling molecule that helps blood vessels relax and widen.

The Two-Step Conversion: Nitrate to Nitrite to Nitric Oxide

The pathway has two steps, and the first happens outside your body. Bacteria on the surface of your tongue reduce nitrate to nitrite, and that depends on your oral microbiome, not your liver or stomach. Once swallowed, the nitrite is absorbed and a second conversion turns it into nitric oxide in the blood and tissues. That first step is the part most people never hear.

Why the Mouth Matters

Because step one is bacterial, anything that disrupts your oral bacteria changes how much nitrite reaches your blood. Antibacterial mouthwash is the clearest example, and we cover it below.

Nitric oxide helps blood vessels relax and widen, and it supports healthy circulation. Beetroot simply supplies the nitrate your body uses to make it.

Agape Nutrition has carried practitioner-grade options in this category since 1998. For more on the mouth and the enzymes involved, see the team's nitric oxide support guide. A dedicated nitric oxide product such as Neo40 Daily 30 Tablets applies the same pathway in a form you can take on a fixed daily schedule.

What the Trials Actually Used: Beetroot Dosage

When a study says it tested beets, the number that matters is not grams of beet. It is milligrams of nitrate.

Beetroot Dosage Landmarks

Across the human trials, the range runs from about 200 to 800 mg of nitrate per day, and most studies cluster at one of two points:

• 400 mg per day: about 70 mL of concentrated juice, or roughly 6.4 mmol.
• 800 mg per day: about 140 mL of the same juice.

When you read that a study used beetroot juice for blood pressure, it almost always means one of those two doses.

A "shot" is not a marketing unit. In the research, 70 mL of concentrated juice is about 400 mg of nitrate. That is the number to look for.

Whole beets and generic beet powder vary widely, because nitrate content depends on soil, growing conditions, and processing, which is why trials standardize on juice with a measured nitrate figure.

Beetroot Juice for Blood Pressure: What the Evidence Shows

This is the most studied outcome for beetroot, and also where honesty matters most. The evidence is real, but it is not unanimous, and the certainty is lower than most marketing implies.

The 2024 Meta-Analysis

The most recent pooled analysis, in Nutrition, Metabolism and Cardiovascular Diseases in 2024, combined 11 trials and 349 participants at doses of 200 to 800 mg per day [1]. It found a mean reduction in clinic systolic blood pressure of 5.31 mmHg (95% CI -7.46 to -3.16).

Two caveats matter. The certainty was graded low, and the trials were heterogeneous with an I-squared of 64 percent. The analysis found no significant effect on clinic diastolic blood pressure or on 24-hour blood pressure.

The 2013 and 2017 Meta-Analyses

An analysis in the Journal of Nutrition in 2013 pooled 16 crossover trials with 254 participants [2]. It reported a systolic reduction of 4.4 mmHg (95% CI -5.9 to -2.8, P < 0.001) and a diastolic reduction of 1.1 mmHg (95% CI -2.2 to 0.1, P = 0.06). That diastolic result did not reach significance.

A 2017 analysis in Advances in Nutrition pooled 22 trials [3]. It found systolic pressure down 3.55 mmHg (95% CI -4.55 to -2.54) and diastolic down 1.32 mmHg (95% CI -1.97 to -0.68). Duration and volume both mattered: trials lasting at least 14 days gave 5.11 versus 2.67 mmHg, and higher daily volumes gave 4.78 versus 2.37 mmHg.

The Negative 2019 Review

A systematic review in the JBI Database of Systematic Reviews and Implementation Reports in 2019 examined 12 papers and 321 participants using narrative synthesis only [4]. Its verdict was blunt: there is insufficient evidence to support or refute the use of inorganic nitrate for blood pressure.

The Ageing Finding

An individual participant meta-analysis in Nitric Oxide in 2015 pooled 4 trials and 85 participants aged 55 to 76 [5]. Nocturnal systolic variability improved in participants under 65, a reduction of 2.8 mmHg (95% CI -4.5 to -1.0, p = 0.002). In participants 65 and older, there was no effect, at 1.0 mmHg (95% CI -2.2 to 4.2, p = 0.54).

The honest summary: pooled trials link beetroot juice to a small, low-certainty reduction in systolic blood pressure, and one systematic review says the evidence is not yet sufficient either way.

If your goal is to support blood pressure already within the normal range, beetroot is one lever among several. The Agape team keeps a wider overview of blood pressure support options.

Beetroot for Exercise Performance: The Signal and the Null

Exercise is where beetroot has the strongest reputation, and where one fact changes the picture.

Endurance: Capacity Is Not the Same as Speed

The key meta-analysis appeared in Sports Medicine in 2017 and combined 47 studies with 76 trials [6]. The results pointed in different directions.

• Time-to-exhaustion improved, effect size 0.33 (95% CI 0.15 to 0.50, p < 0.01), meaning you last longer at a fixed effort.
• Time-trial performance did not improve, effect size -0.10 (95% CI -0.27 to 0.06), meaning you are not faster over a set distance.
• Graded exercise tests showed 0.25 (95% CI -0.06 to 0.56), not significant.

The authors concluded that beetroot helps endurance capacity and is less likely to help time-trial performance. The "beetroot makes you faster" claim is only half true.

If your training sits at the longer-effort end, a beet product built for training days such as SuperBeets Energy Plus Natural Berry 30 Servings is a practical way to work nitrate into the routine.

Beetroot improved time-to-exhaustion in the pooled data, but the effect on time-trial performance was trivial and not statistically significant.

Short High-Intensity Bouts

A 2023 meta-analysis in Antioxidants looked at single and repeated bouts of short, high-intensity work, reviewing 27 studies and pooling 23 [7]. Time to peak power improved with a standardized mean difference of 0.75 (p = 0.02), mean power output by 0.20 (p = 0.02), and Yo-Yo intermittent recovery distance by 0.17 (p < 0.0001). These are small to moderate effects, but they show a signal beyond steady-state endurance, making it one input among many in the endurance athlete toolkit.

Strength and Resistance Training

For strength, the effect sizes are telling. A 2022 meta-analysis in Critical Reviews in Food Science and Nutrition reviewed 34 studies [8]. Muscular strength improved by a standardized mean difference of 0.08, which the authors called trivial, even though the p-value was 0.024. Muscular endurance improved by 0.31, which they called small.

A 2023 meta-analysis in Nutrients focused on back squat and bench press performance across 6 studies in resistance-trained males [9]. Repetitions-to-failure improved by a standardized mean difference of 0.43 (95% CI 0.156 to 0.699, p = 0.002), and mean power by 0.40 (95% CI 0.127 to 0.678, p = 0.004). Peak power was 0.204 (p = 0.054) and did not reach significance.

The pattern is consistent: beetroot helps you do a bit more work before failure, mostly in endurance-type effort, and it does very little for maximal strength. Pair it with a sound muscle recovery plan.

Older Adults, Cognition, and Cerebral Blood Flow

Beetroot is often sold as a brain supplement, since nitric oxide supports blood flow and the brain needs blood flow. The direct evidence is thinner than that logic suggests, and one important trial came back null.

The 2015 Acute Study

A double-blind, placebo-controlled study in Physiology and Behavior in 2015 tested 40 healthy adults [10]. Participants drank 450 mL of beetroot juice, about 5.5 mmol of nitrate, with a 90-minute absorption period. It found improved performance on the serial 3s subtraction task and changes in the cerebral blood flow response to the task. That is a positive acute result in healthy adults, not evidence of long-term brain health.

The 2022 13-Week Null

The more important study for daily use is a 13-week dose-ranging pilot in Nutrients in 2022 [11]. It enrolled 62 overweight or obese adults aged 60 to 75 and compared 140 mL per day (about 800 mg), 70 mL per day (about 400 mg), 70 mL on alternate days, and a nitrate-depleted placebo. The result was null: no dose-dependent effect on cognition or cerebral blood flow. The doses were confirmed in the trial's protocol [12], so this is not accidental underdosing.

A single acute dose improved a mental tracking task in healthy adults. A 13-week trial at doses up to 800 mg found no effect on cognition or cerebral blood flow.

Heart Failure Trials: What Two Studies Found

Two small trials give the clearest signals in the field, and a third gives a clean null. We report them as study findings.

The first, in JACC: Heart Failure in 2016, enrolled 20 patients with heart failure and preserved ejection fraction, aged about 69 [13]. They received 6.1 mmol of nitrate daily for one week. Time to exhaustion at 75 percent of maximal power improved by 24 percent (p = 0.02). A single dose did nothing; the benefit appeared only with daily dosing for a week, and no adverse events were reported.

The second, in Circulation Research in 2017, examined the pharmacokinetics of inorganic nitrate in the same population [14]. It used potassium nitrate at 6 mmol twice daily, then three times daily. Peak oxygen uptake did not improve (P = 0.13), but exercise duration rose from 9.87 to 10.73 to 11.61 minutes (P = 0.002). Maximum systolic pressure dropped by 17.9 mmHg (95% CI -28.3 to -7.6) at 3.75 hours, with no clinically significant hypotension and no methemoglobinemia.

Then the null. A trial in the American Journal of Physiology in 2017 enrolled 13 patients with heart failure and reduced ejection fraction, and 10 completed 9 days of supplementation [15]. Time to exercise intolerance was 495 seconds versus 489 seconds with placebo, not significant, even though plasma nitrite rose from 56 to 240 nM. Population, dose duration, and outcome all change the answer.

Timing: When to Take Beetroot

Timing is where the pathway becomes practical. Plasma nitrite peaks at roughly 1 to 3 hours, and a pharmacokinetic study in Circulation Research in 2017 put the median nitrate half-life at about 73 minutes [14].

Pre-Exercise Timing

For performance, take your nitrate about 2 to 3 hours before you start. That lands the plasma nitrite peak near the start of your effort, when the trials measured their effects.

• 2 to 3 hours before: the standard window across the endurance studies.
• 1 to 3 hours: the broader peak range if you need to compress the schedule.
• Split timing for very long events: some protocols use a dose the night before plus one on the day.

A Daily Routine for Blood Pressure Support

For circulation and blood pressure support, consistency matters more than timing. The trials that showed the larger effects ran at least 14 days [3]. Pick a fixed time each day, give it at least two weeks before you judge anything, and keep the dose inside the studied range rather than guessing high.

Consistency beats timing for daily use. The trials that showed the bigger effects ran at least 14 days.

The Mouthwash Factor

Because the first step of the nitrate pathway happens in your mouth, an antibacterial mouthwash can blunt the entire process.

A 2008 crossover study in the journal Nitric Oxide tested 7 volunteers [16]. Each received sodium nitrate at 10 mg/kg, with or without a chlorhexidine antibacterial rinse. The mouthwash did not change how much nitrate accumulated, but it abolished the salivary conversion of nitrate to nitrite and markedly attenuated the rise in plasma nitrite.

A 2019 systematic review in Frontiers in Physiology added nuance [17]. Across 6 studies and 82 participants, 4 of 6 found that mouthwash correlated with lower plasma nitrite, and only 3 of 5 suggested a significant systolic blood pressure increase after mouthwashing. Oral bacteria clearly regulate salivary nitrate metabolism, but the effect on circulating nitric oxide species remains ambiguous.

A related study in Free Radical Biology and Medicine in 2019 tracked 22 vegetarians and 19 omnivores [18]. One week of antibacterial mouthwash lowered nitrate-reducing species by about 17 percent and cut oral reducing capacity by 78 to 85 percent, without a significant change in blood pressure in healthy young people.

An antibacterial rinse abolished the salivary conversion of nitrate to nitrite in a small crossover study and markedly attenuated the plasma nitrite rise.

The practical implication: if you take a beetroot supplement, do not use an antiseptic mouthwash right around your dose.

Beetroot Supplement Side Effects and Who Should Be Careful

Beetroot is generally well tolerated at the doses the trials used, and the larger heart failure trial reported no adverse events. A few specific cautions still belong on the page, however.

Beeturia: Harmless but Surprising

The most common side effect is beeturia, red or pink urine and stool after eating beets or taking a beetroot supplement. It is harmless, and it happens because some people excrete beet pigments more visibly than others.

Oxalates and Kidney Stone History

Beets contain oxalates, which matter for people with a history of kidney stones. Beet oxalate availability is lower than spinach, and cooking reduces it further, so beets are not the highest-oxalate choice on the plate. Still, if you have a stone history, talk with your clinician before adding a daily dose.

Gout Considerations

If you have gout risk or a history of gout, be thoughtful with any concentrated vegetable or supplement product and check with your clinician first, since concentrated products differ from whole vegetables.

Nitrate, Blood Pressure Medication, and Interactions

This is the caution that matters most. Nitrate from food and supplements can interact with certain medications, including blood pressure medications and nitrate-based drugs, and the effects can stack.

• If you take blood pressure medication, talk with your clinician before starting a nitrate supplement.
• If you take any nitrate-based prescription, do not add a nitrate supplement without medical guidance.
• Do not stop or change prescribed blood pressure medication to try beetroot. This is not negotiable.

Beetroot is a dietary supplement, not a replacement for prescribed care. Agape Nutrition has sold practitioner-grade supplements since 1998, led by Stephen Smith, M.D., and the team's standing advice is that supplements support normal function alongside medical care.

Juice, Powder, Capsules, or Chews: The Form Question

Beetroot comes in several forms, and they are not interchangeable.

• Concentrated juice: the form used in most trials, easy to dose at about 400 mg per 70 mL, but taste is a factor and it needs refrigeration once opened.
• Beetroot powder: convenient and shelf-stable, though nitrate content varies widely by brand and batch.
• Capsules and tablets: easy to take and travel-friendly, but often lower nitrate per serving.
• Chews: portable and pleasant, though nitrate per chew varies widely.

Reading a Beetroot Supplement Label

Front-of-pack claims tell you almost nothing. The back panel is where the dose lives. Check these:

1. Nitrate per serving, in milligrams, if the brand states it. This is the number trials care about.
2. Beetroot content per serving, if no nitrate figure is given.
3. Serving size versus package size, since a big bottle with a tiny serving can still underdeliver.
4. Other active ingredients, since blends with multiple nitric oxide ingredients change what you get.
5. Third-party testing or a certificate of analysis, which signals a standardized product.

A product that lists a nitrate figure and a clear serving size lets you compare it directly to the trial doses of 400 mg or 800 mg per day. A product that lists only "beet root" leaves you guessing. For a wider view, the store's heart and circulation hub compares options side by side.

The Non-Supplement Foundation

Beetroot is one lever, and it only makes sense on top of the basics. Dietary nitrate comes from vegetables, and a food-first approach is where the pathway starts. Nitrate-rich vegetables include leafy greens such as arugula, spinach, and lettuce, along with beets themselves, so a diet built around them gives you a steady supply without any supplement at all.

The broader point matters more than any single food. Healthy circulation and healthy blood pressure rest on the whole pattern: regular movement, enough sleep, stress management, hydration, and a vegetable-rich diet. A nitrate supplement can support that pattern; it cannot substitute for it.

Beetroot is one lever among several. It supports a healthy routine, it does not replace one.

If you are earlier in the process and want the wider picture, the team's article on circulation support options is a useful starting point.

What We Recommend

If you want to put the doses and forms above into practice, these are the beetroot and nitric oxide products the store currently stocks, ordered from the one with the strongest sales signal to the broadest stock depth.

References

1. Effects of beetroot juice on blood pressure in hypertension: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024;34(10):2240-2256. https://pubmed.ncbi.nlm.nih.gov/39069465/
2. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr 2013;143(6):818-826. https://pubmed.ncbi.nlm.nih.gov/23596162/
3. The nitrate-independent blood pressure-lowering effect of beetroot juice: a systematic review and meta-analysis. Adv Nutr 2017;8(6):830-838. https://pubmed.ncbi.nlm.nih.gov/29141968/
4. Effectiveness of dietary inorganic nitrate for lowering blood pressure in adults: a systematic review. JBI Database System Rev Implement Rep 2019;17(3):365-389. https://pubmed.ncbi.nlm.nih.gov/30870330/
5. Ageing modifies the effects of beetroot juice supplementation on 24-hour blood pressure variability: an individual participant meta-analysis. Nitric Oxide 2015;47:97-105. https://pubmed.ncbi.nlm.nih.gov/25937622/
6. The effect of dietary nitrate supplementation on endurance exercise performance in healthy adults: a systematic review and meta-analysis. Sports Med 2017;47(4):735-756. https://pubmed.ncbi.nlm.nih.gov/27600147/
7. Effects of dietary nitrate supplementation on performance during single and repeated bouts of short-duration high-intensity exercise: a systematic review and meta-analysis. Antioxidants (Basel) 2023. https://pubmed.ncbi.nlm.nih.gov/37371924/
8. Effect of dietary nitrate ingestion on muscular performance: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2022. https://pubmed.ncbi.nlm.nih.gov/33554654/
9. Effects of dietary nitrate supplementation on back squat and bench press performance: a systematic review and meta-analysis. Nutrients 2023. https://pubmed.ncbi.nlm.nih.gov/37299456/
10. Dietary nitrate modulates cerebral blood flow parameters and cognitive performance in humans: a double-blind, placebo-controlled investigation. Physiol Behav 2015;149:149-158. https://pubmed.ncbi.nlm.nih.gov/26037632/
11. Incremental doses of nitrate-rich beetroot juice do not modify cognitive function and cerebral blood flow in overweight and obese older adults: a 13-week pilot randomised clinical trial. Nutrients 2022;14(5):1052. https://pubmed.ncbi.nlm.nih.gov/35268027/
12. Incremental doses of nitrate-rich beetroot juice in overweight and obese older adults: study protocol for a randomised controlled trial. Contemp Clin Trials Commun 2020;18:100571. https://pubmed.ncbi.nlm.nih.gov/32405570/
13. One week of daily dosing with beetroot juice improves submaximal endurance and blood pressure in older patients with heart failure and preserved ejection fraction. JACC Heart Fail 2016. https://pubmed.ncbi.nlm.nih.gov/26874390/
14. Pharmacokinetics and pharmacodynamics of inorganic nitrate in heart failure with preserved ejection fraction. Circ Res 2017. https://pubmed.ncbi.nlm.nih.gov/27927683/
15. Dietary nitrate supplementation and exercise tolerance in patients with heart failure with reduced ejection fraction. Am J Physiol Regul Integr Comp Physiol 2017. https://pubmed.ncbi.nlm.nih.gov/27784687/
16. The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. Nitric Oxide 2008;19(4):333-337. https://pubmed.ncbi.nlm.nih.gov/18793740/
17. Do changes in oral microbiota correlate with plasma nitrite response? A systematic review. Front Physiol 2019;10:1029. https://pubmed.ncbi.nlm.nih.gov/31456696/
18. Dietary intake of inorganic nitrate in vegetarians and omnivores. Free Radic Biol Med 2019;138:63-72. https://pubmed.ncbi.nlm.nih.gov/31082507/

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