tuneTypical Dose
Roughly 5 to 9.9 mmol/day in multi-day protocols, or 5 to 14.9 mmol acutely before exercise
Supplement
Dietary Nitrates
Inorganic nitrates
Evidence TierCWADA NOT PROHIBITED
watchEffect Window
Acute effects depend on timing. Multi-day loading is also used in some performance protocols.
check_circleCompliance
WADA NOT PROHIBITED
Overview
Clinical Summary
Dietary nitrates can modestly improve some endurance outcomes and may lower systolic blood pressure, but the effect depends on dose, timing, source, and preservation of the oral nitrate-to-nitrite pathway.
Dietary nitrates are one of the more legitimate nitric-oxide-oriented interventions, but their benefit is smaller and more conditional than supplement marketing implies. The best human evidence supports a modest ergogenic effect in some endurance settings and a modest blood-pressure effect in some hypertensive adults. Results depend heavily on dose, timing, and source, and the better meta-analysis suggests nitrate-rich beetroot performs better than nitrate salts.
Dietary nitrate is reduced to nitrite by oral bacteria and can then contribute to nitric-oxide signaling, particularly under low-oxygen conditions. That pathway helps explain vascular and performance effects, but it also means mouthwash use, source, and timing can materially affect outcomes.
Outcomes
What This Is Expected To Influence
Primary Outcomes
- Small improvement in some endurance-performance settings
- Modest reduction in clinic systolic blood pressure in some hypertensive adults
Secondary Outcomes
- Beetroot-derived nitrate appears more consistently effective than nitrate salts
- Benefit is sensitive to timing and oral-microbiome disruption
Safety
Contraindications and Interactions
Contraindications
- Symptomatic hypotension
Side effects
- Mild GI upset
- Lightheadedness from blood-pressure lowering
Interactions
- Antihypertensive medications
- PDE-5 inhibitors
- Other nitric-oxide-targeting supplements
Avoid if
- You are prone to low blood pressure or vasodilator-related dizziness
- You are assuming all nitrate products are interchangeable
Evidence
Study-level References
dn-SRC-001Systematic review and meta-analysis
Sourceopen_in_newSilva KVC, Costa BD, Gomes AC, et al. Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults. A systematic review with meta-analyses and meta-regressions. Adv Nutr. 2022;13(5):1866-1881. doi:10.1093/advances/nmac054. PMID:35580578.
Population: Healthy adults enrolled in randomized controlled trials of inorganic nitrate supplementation from beetroot juice, nitrate salts, or nitrate-rich diets.
Dose protocol: Acute 5 to 14.9 mmol at least 150 minutes before exercise, or 5 to 9.9 mmol/day in multi-day protocols
Key findings: Small but significant exercise-performance benefit, with beetroot juice and nitrate-rich diets outperforming nitrate salts in source comparisons.
Notes: Core evidence anchor for ergogenic framing.
Paper content
This large meta-analysis supports a real but small ergogenic effect for nitrate supplementation, with beetroot juice performing better than nitrate salts. The main practical lessons are that benefit depends on nitrate dose, exercise type, timing, and preservation of the oral nitrate-reduction pathway. This is strong support for nitrate-standardized beetroot products, but not for generic beetroot extracts that do not disclose nitrate content.
dn-SRC-002Systematic review and meta-analysis
Sourceopen_in_newGrönroos R, Eggertsen R, Bernhardsson S, et al. Effects of beetroot juice on blood pressure in hypertension according to European Society of Hypertension Guidelines. A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2024;34(10):2340-2349. doi:10.1016/j.numecd.2024.06.009. PMID:39069465.
Population: Adults with hypertension meeting guideline criteria in randomized controlled trials of beetroot juice.
Dose protocol: 200 to 800 mg nitrate daily from beetroot juice in hypertensive adults
Key findings: Lowered clinic systolic blood pressure modestly in hypertensive adults.
Notes: Best current BP framing source even though the intervention is beetroot derived.
Paper content
This 2024 meta-analysis is the best current source for blood-pressure framing. It found a modest reduction in clinic systolic blood pressure in hypertensive adults, but no clear pooled effect on diastolic or ambulatory blood pressure, and the certainty of evidence was low. That supports cautious, adjunctive use framing rather than treating beetroot juice as a replacement for antihypertensive therapy.
dn-SRC-003Double-blind, randomized crossover trial.
Sourceopen_in_newMcLellan AG, Acton JP, O'Donnell E, et al. The dose-response effects of nitrate-rich beetroot ingestion on cardiovascular and endothelial function: a randomised controlled trial. Food Funct. 2026. doi:10.1039/d5fo05298j. PMID:41704173.
Population: Healthy adults.
Dose protocol: Acute 200 mg, 400 mg, or 800 mg nitrate from beetroot powder versus placebo in healthy adults (crossover)
Key findings: Arterial stiffness improved at all doses. Endothelial function improved only at 400 mg (+3.07%). Aortic systolic BP improved only at 800 mg (-4 mmHg).
Notes: Useful dose-response data showing different cardiovascular endpoints have different nitrate thresholds.
Paper content
This double-blind randomized crossover trial tested three acute doses of nitrate-rich beetroot powder (200, 400, and 800 mg nitrate) against placebo in healthy adults. Arterial stiffness markers improved at all doses. Endothelial function improved only at the 400 mg dose, while aortic systolic blood pressure improved only at the 800 mg dose (-4 mmHg). Brachial blood pressure did not change significantly at any dose. The study demonstrates a dose-dependent pattern for different cardiovascular endpoints and supports the idea that different outcomes may require different nitrate thresholds.
dn-SRC-004Randomized, double-blind, placebo-controlled trial
Sourceopen_in_newRamos Junior OJF, de Souza Filho CA, Majeed S, Alvares TS. Long-Term Beetroot Extract Supplementation Improves Morphological Muscle Quality and Rate of Force Development in Postmenopausal Women: A Randomized Clinical Trial. Nutrients. 2026;18(5):860. doi:10.3390/nu18050860. PMID:41830030.
Population: Postmenopausal women averaging 21 years post-menopause.
Dose protocol: 548 mg nitrate/day from beetroot extract versus nitrate-depleted placebo for 12 weeks in 20 postmenopausal women
Key findings: Improved morphological muscle quality, rate of force development, and maximal voluntary isometric contraction by week 12.
Notes: One of the first long-term nitrate trials demonstrating musculoskeletal benefits in a vulnerable population. Small sample size but consistent signal.
Paper content
This 12-week RCT in 20 postmenopausal women found that nitrate-rich beetroot extract (548 mg nitrate per day) significantly improved morphological muscle quality and rate of force development compared with a nitrate-depleted placebo. Serum nitrate and nitrite levels rose significantly in the treatment group. The authors suggest potential clinical relevance for preventing structural and neuromuscular decline in postmenopausal women.