Scientifically Supported Health Benefits of Beetroot
1. Blood pressure
A 2024 meta-analysis of eleven randomised controlled trials in 349 patients with clinically diagnosed hypertension found beetroot juice reduced clinic systolic blood pressure by 5.31 mmHg, at doses of 200 to 800 mg of nitrate a day [1]. In the largest single trial, 68 hypertensive patients took 250 ml of beetroot juice daily for four weeks against a nitrate-depleted placebo; clinic blood pressure fell by 7.7/2.4 mmHg and 24-hour ambulatory pressure by 7.7/5.2 mmHg, with no sign of the effect fading over the four weeks [2].
2. The nitrate pathway and the bacteria that run it
Humans have no working nitrate reductase of their own. Around a quarter of ingested nitrate is concentrated by the salivary glands, and commensal bacteria on the tongue reduce it to nitrite, which becomes nitric oxide. Three separate human studies have demonstrated the dependency by removing it: antibacterial mouthwash cut oral nitrite production by 90 per cent, lowered plasma nitrite by 25 per cent, and raised blood pressure by 2 to 3.5 mmHg [3][4].
3. Exercise tolerance
An umbrella review of twenty systematic reviews, covering 180 primary studies and 2,672 participants, found dietary nitrate improved time to exhaustion, total distance covered, muscular endurance and peak power output. Effects were more pronounced at 6 mmol a day or more, taken for more than three days [5].
4. The oxygen cost of exercise
In the foundational trial, eight men took 500 ml of beetroot juice daily for six days. Muscle oxygen extraction during moderate exercise fell by around 19 per cent, the oxygen cost of exercise dropped, and time to exhaustion extended [6]. A later dose-response study established the ceiling: 8.4 mmol of nitrate produced the full performance benefit, and doubling it to 16.8 mmol added nothing further [7].
5. Vascular function
A meta-analysis of twelve randomised controlled trials in 246 participants found beetroot improved vascular function, with the effect proportional to nitrate dose [8]. A larger synthesis of 27 trials found pulse wave velocity fell by 0.27 m/s and flow-mediated dilation rose by 0.62 percentage points [9].
6. Muscle recovery
A meta-analysis of nine human trials found beetroot juice improved recovery of isometric strength at 72 hours and countermovement jump performance between 24 and 72 hours after damaging exercise, and raised the pressure pain threshold at 48 hours [10]. In one controlled trial, 30 men performed 100 drop jumps; those on the higher dose recovered jump performance significantly better at 48 and 72 hours [11].
7. Redox balance
In a randomised placebo-controlled crossover in fifteen older adults with hypertension, four weeks of nitrate-rich beetroot juice improved the ratio of oxidised to total LDL and raised the glutathione to glutathione-disulfide ratio, both significantly against nitrate-depleted placebo [12].
8. Betaine and folate
Beetroot is among the richest common dietary sources of betaine, at 300 to 480 mg per 100 g of fresh root [13], and carries 109 µg of folate per 100 g [14]. Folate contributes to normal homocysteine metabolism, to normal blood formation, and to the reduction of tiredness and fatigue.
References
- Grönroos R, Eggertsen R, Bernhardsson S, Praetorius Björk M. Effects of beetroot juice on blood pressure in hypertension: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2024;34(10):2240–2256. doi:10.1016/j.numecd.2024.06.009 · PMID 39069465
- Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study. Hypertension. 2015;65:320–327. doi:10.1161/HYPERTENSIONAHA.114.04675 · PMID 25421976
- Kapil V, Haydar SMA, Pearl V, Lundberg JO, Weitzberg E, Ahluwalia A. Physiological role for nitrate-reducing oral bacteria in blood pressure control. Free Radic Biol Med. 2013;55:93–100. doi:10.1016/j.freeradbiomed.2012.11.013 · PMID 23183324
- Bondonno CP, Liu AH, Croft KD, et al. Antibacterial mouthwash blunts oral nitrate reduction and increases blood pressure in treated hypertensive men and women. Am J Hypertens. 2015;28:572–575. doi:10.1093/ajh/hpu192 · PMID 25359409
- Poon ET-C, Iu JC-K, Sum WM-K, et al. Dietary nitrate supplementation and exercise performance: an umbrella review of 20 published systematic reviews with meta-analyses. Sports Med. 2025;55:1213–1231. doi:10.1007/s40279-025-02194-6 · PMID 40085422
- Bailey SJ, Winyard P, Vanhatalo A, et al. Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans. J Appl Physiol. 2009;107(4):1144–1155. doi:10.1152/japplphysiol.00722.2009 · PMID 19661447
- Wylie LJ, Kelly J, Bailey SJ, et al. Beetroot juice and exercise: pharmacodynamic and dose-response relationships. J Appl Physiol. 2013;115:325–336. doi:10.1152/japplphysiol.00372.2013 · PMID 23640589
- Lara J, Ashor AW, Oggioni C, Ahluwalia A, Mathers JC, Siervo M. Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis. Eur J Nutr. 2016;55:451–459. doi:10.1007/s00394-015-0872-7 · PMID 25764393
- Bahrami LS, Arabi SM, Feizy Z, Rezvani R. The effect of beetroot inorganic nitrate supplementation on cardiovascular risk factors: a systematic review and meta-regression of randomized controlled trials. Nitric Oxide. 2021;115:8–22. doi:10.1016/j.niox.2021.06.002 · PMID 34119659
- Jones L, Bailey SJ, Rowland SN, et al. The effect of nitrate-rich beetroot juice on markers of exercise-induced muscle damage: a systematic review and meta-analysis of human intervention trials. J Diet Suppl. 2022;19(6):749–771. doi:10.1080/19390211.2021.1939472 · PMID 34151694
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- Fejes R, Pilat N, Lutnik M, et al. Effects of increased nitrate intake from beetroot juice on blood markers of oxidative stress and inflammation in older adults with hypertension. Free Radic Biol Med. 2024;222:519–530. doi:10.1016/j.freeradbiomed.2024.07.004 · PMID 38972612
- Lee EJ, An D, Nguyen CTT, Patil BS, Kim J, Yoo KS. Betalain and betaine composition of greenhouse- or field-produced beetroot and inhibition of HepG2 cell proliferation. J Agric Food Chem. 2014;62(6):1324–1331. doi:10.1021/jf404648u · PMID 24467616
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- Siervo M, Lara J, Ogbonmwan I, Mathers JC. Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis. J Nutr. 2013;143:818–826. doi:10.3945/jn.112.170233 · PMID 23596162
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- Chazelas E, Pierre F, Druesne-Pecollo N, et al. Nitrites and nitrates from food additives and natural sources and cancer risk: results from the NutriNet-Santé cohort. Int J Epidemiol. 2022;51(4):1106–1119. doi:10.1093/ije/dyac046 · PMID 35303088
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