Beetroot (dietary nitrate)

This page grades four outcomes separately. Endurance and muscle power are listed under physical performance; blood pressure and blood vessel function are under healthy aging. Grades follow how we grade evidence.

Does beetroot improve endurance?

Pooled trials in young adults found a small benefit. In an NIH-funded meta-analysis of 80 randomized, placebo-controlled crossover studies in young, healthy adults, exercise performance improved with nitrate compared with placebo (d = 0.174, 95% CI 0.120 to 0.229), which the authors called objectively small [1]. The effect was not seen in well-trained endurance athletes (26 studies; d = 0.021) or in studies of women only (6 studies) [1]. Of the 111 studies the authors tallied, 76 found no difference on their own and none found worse performance [1].

The type of test matters. A meta-analysis of 73 placebo-controlled studies (1,061 participants, no funding) found longer time to exhaustion (25.3 seconds) and more power output (4.6 watts), but no significant difference in time-trial performance or perceived exertion [2]. An earlier meta-analysis of 47 studies in healthy adults found a small to moderate effect in time-to-exhaustion trials (ES 0.33) and no significant pooled effect overall [5]. Nitrate lowered oxygen uptake during exercise, with no significant effect on VO2max [2].

A 2025 umbrella review that pooled 20 earlier meta-analyses (180 studies, 2,672 participants; no specific funding) found mixed effects: time to exhaustion improved (SMD 0.33), as did total distance, muscular endurance and peak power, while the other performance outcomes did not change significantly [3]. Subgroups given at least 6 mmol (372 mg) a day for more than 3 days showed larger gains in time to exhaustion [3]. It rated most of the included reviews as low or critically low quality [3].

Results in athletes are weaker. A 2026 meta-analysis of 45 randomized, placebo-controlled trials in 659 athletes found no significant pooled effect on any of six outcomes, and its authors note this is not definitive evidence of no effect [4].

Does beetroot increase muscle power or strength?

For power, an NIH-funded individual participant data meta-analysis of 19 double-blind, placebo-controlled crossover studies (268 participants, 218 of them men) found higher maximal muscle power (Hedges' g 0.42), about 5% on average [7]. The effect was larger after a single dose (g 0.54) than with multiple-day dosing (g 0.22) [7]. The 2025 umbrella review also found higher peak power output (SMD 0.25) and muscular endurance (SMD 0.48) [3].

For strength, the effect is smaller. A meta-analysis of 34 trials found a trivial effect on muscular strength (SMD 0.08) and a small effect on muscular endurance (SMD 0.31) [8]. In 6 studies of resistance-trained men, nitrate increased repetitions to failure (SMD 0.43), mean power (SMD 0.40) and mean velocity (SMD 0.57), but not peak power or peak velocity with squat and bench press combined; the authors noted few studies and large variability [9]. The 2026 athlete meta-analysis found no significant pooled effect on any of its six outcomes [4].

Does beetroot affect blood pressure?

Short trials found lower systolic pressure. A meta-analysis of 16 randomized crossover trials (254 participants, lasting 2 hours to 15 days) found that nitrate or beetroot juice was associated with a 4.4 mmHg fall in systolic blood pressure, with no significant change in diastolic pressure (-1.1 mmHg) [10]. Larger daily doses were linked with larger falls, and the authors called for long-term trials [10]. A later meta-analysis of 23 studies found systolic pressure 4.80 mmHg lower and diastolic pressure 1.74 mmHg lower [11].

In older adults, a meta-analysis of 22 randomized trials found that nitrate reduced systolic pressure by 3.90 mmHg and diastolic pressure by 2.62 mmHg [12]. That review found no significant change in participants who had hypertension at baseline, and no significant change when pressure was measured over 24 hours or at home [12]. A dose-response meta-analysis of 75 randomized trials (1,823 participants) found systolic pressure fell by 0.28 mmHg for each extra mmol of nitrate in acute studies and by 0.48 mmHg in medium-term studies [16].

Longer and clinical trials are less consistent. A 2026 meta-analysis of six placebo-controlled trials of sodium nitrate lasting at least a week (181 adults, mostly over 50) found no significant reduction in systolic or diastolic pressure; it excluded beetroot juice trials [15]. A 16-week, double-blind exploratory trial funded by the Canadian Institutes of Health Research in 66 adults with raised blood pressure compared high-nitrate vegetable powder (about 400 mg nitrate) with low-nitrate vegetable powder (about 50 mg) and found no difference in office systolic pressure [14]. In adults with diagnosed hypertension (a clinical population), a meta-analysis of 11 trials found clinic systolic pressure 5.31 mmHg lower with beetroot juice, no effect on 24-hour readings, and low certainty of evidence; results may not apply to healthy adults [13].

Does beetroot improve blood vessel function?

Blood vessel function here means flow-mediated dilation and related measures of how well arteries widen, which is a separate outcome from blood pressure. A meta-analysis funded by the Medical Research Council pooled 12 randomized trials (246 participants, 1.5 hours to 28 days) and found improved vascular function with nitrate or beetroot (SMD 0.36) [17]. The effect appeared smaller in older people and in people with greater cardiometabolic risk [17].

A meta-analysis of 23 studies found flow-mediated dilation 0.59% higher and pulse wave velocity, a measure of arterial stiffness, 0.23 m/s lower [11]. A 2026 meta-analysis of 13 trials found flow-mediated dilation 1.48% higher than control, with very high heterogeneity (I2 = 98.2%) and a larger response in acute than chronic studies (1.93% versus 0.90%) [18]. The dose-response meta-analysis found 0.30% more dilation per extra mmol of nitrate in medium-term studies [16]. Its authors call for higher-quality, population-specific trials [16]. Related page: cocoa flavanols.

What the evidence does not show

Benefits for well-trained athletes are not shown: an NIH-funded meta-analysis found no significant effect in well-trained endurance athletes, and a 2026 meta-analysis of athlete trials found no significant pooled effect [1][4]. Pooled trials found no significant effect on VO2max or time-trial performance [2]. NIH ODS notes that no research has assessed beetroot nitrate as an ergogenic aid beyond several weeks [33], and the reviews behind the blood pressure grade called for long-term trials [10][11].

After a single dose, plasma nitrite rose with dose and peaked about 2-3 hours later [6]. In a crossover trial in 11 healthy adults, 250 mL of beetroot juice with 572 mg of nitrate raised plasma nitrate and nitrite after 2 hours, and both were still higher after 6 hours [20]. In that trial, the expected fall in systolic and diastolic pressure was not observed [20]. In the power meta-analysis, effects were larger after single doses than with multiple-day regimens [7].

Most studies used juice or juice concentrate; NIH ODS notes that studies have not assessed whether beetroot powder supplements work the same way [33].

The main safety question is nitrate itself. A systematic review of beetroot juice warns that drinking it may easily raise nitrate intake above the acceptable daily intake, and that such intake stimulates the body's own formation of N-nitroso compounds, a class the review describes as carcinogenic [21]. The same review found less research on harms than on benefits [21]. A review of drinking-water nitrate reports that an IARC working group concluded that ingested nitrate and nitrite, under conditions that result in endogenous nitrosation, are probably carcinogenic [22]. That review adds that vitamin C, polyphenols and other compounds in most vegetables inhibit this process, so nitrate from vegetables may not lead to substantial formation [22]. It also reports preliminary data in 29 young people: one bottle of beetroot juice with 400 mg nitrate a day raised urinary nitroso compounds, and 1 g a day of vitamin C only partly reduced this [22].

The acceptable daily intake (ADI) for nitrate of 3.7 mg/kg body weight per day was set by the Scientific Committee on Food (SCF, 1997) and JECFA (2002), and in 2017 EFSA concluded there was insufficient evidence to withdraw it [23]. EFSA calculated that nitrate at the ADI, even with the highest nitrate-to-nitrite conversion factor, would raise methemoglobin measurably but not to a clinically significant level [23]. It also found that, counting all dietary sources, the ADI would be exceeded for all age groups at mean and high exposure [23].

Trial data on side effects are limited [21]. In a preliminary 12-week randomized, placebo-controlled trial in older adults, no serious adverse events were reported with 20 g a day of a beetroot extract or with placebo; two of the authors are employed by the Sami-Sabinsa Group, which makes the extract [25]. NIH ODS states that studies have not found safety concerns with about 2 cups of beetroot juice a day for several weeks [33]. Beeturia, pink or red urine after eating beetroot, is reported in 10-14% of people and is more common with iron deficiency and malabsorption [24]. As of November 11, 2026, we found no human study of beetroot supplements and kidney stones (PubMed search, November 11, 2026).

The interaction evidence we found concerns agents that weaken the blood pressure effect of nitrate. A review lists antiseptic mouthwash, proton pump inhibitors, high concentrations of ascorbate (vitamin C), thiocyanate from diet and smoking, and xanthine oxidoreductase inhibitors as agents that impair blood pressure responses to nitrate and nitrite [27]. In 19 healthy volunteers not given nitrate supplements, 7 days of chlorhexidine mouthwash cut oral nitrite production by 90% and plasma nitrite by 25%, and blood pressure rose by 2 to 3.5 mmHg [19].

For stomach-acid medicines, a randomized, double-blind crossover trial in 15 healthy adults found that the proton pump inhibitor esomeprazole blunted the fall in systolic pressure after oral sodium nitrite [26]. That trial tested nitrite, not nitrate. As of November 11, 2026 we found no study testing dietary nitrate together with blood pressure medicines or PDE5 inhibitors such as sildenafil (PubMed search, November 11, 2026).

If you take any of these medicines, talk to your doctor or pharmacist before combining them with beetroot or nitrate supplements.