Beet juice: it lowers blood pressure, and not through the nitrate

Twenty-two trials say beetroot juice lowers systolic pressure by about 3.5 mmHg. Inside the same analysis sits a result that undoes the explanation everyone gives: more juice worked better, and juice with more nitrate per millilitre worked worse. The authors call the effect nitrate-independent. A 2026 meta-analysis that deliberately excluded beetroot and tested sodium nitrate on its own found no blood pressure reduction at all. So the whole juice does something and the compound it is sold for does not, and nobody has identified what else in it is responsible.

What a real portion looks like

• For repeated sprints the dose that showed anything was about 70 millilitres of concentrate twice a day for three to six days, and the gain was a few percent. — 18 studies in people performing repeated sprint exercise (n = 18 studies) Evidence C source
  In a third of the studies beetroot juice raised plasma nitrite and with it peak power, mean power, sprint repetitions, total work and time to task failure, while lowering fatigue index and sprint times; chronic protocols used about 5 to 6 mmol nitrate in 70 mL twice a day for at least 3 to 6 days, acute protocols 250 to 500 mL taken 2.5 to 3 hours before effort; improvements in fatigue resistance ranged from 1.2% to 5.38%

What your body absorbs

• Only about three thousandths of beetroot's red pigment ever reaches the urine, and the spread between people is fourfold. — 12 volunteers (n = 12) Evidence B source
  About 0.3% of ingested betacyanins was excreted, ranging from 0.12% to 0.58%; peak excretion came in the first 2 hours for juice and at 2 to 4 hours for slices; average total excretion rate ranged from 18.54 to 67.96 nmol/h for juice and 13.15 to 63.58 for slices between individuals; bioavailability was similar for both products

What it does to your health

• Beetroot juice lowered systolic pressure by three and a half millimetres, and the more nitrate a millilitre held the smaller the effect got. — 22 trials conducted between 2009 and 2017, with 47 intervention groups (n=650) and 43 control groups (n=598) (n = 1248) Evidence A source
  Systolic pressure -3.55 mm Hg (95% CI -4.55 to -2.54) and diastolic -1.32 (-1.97 to -0.68); larger with 14 days or more than under 14 days (-5.11 against -2.67) and with 500 mL a day than with 70 or 140 mL (-4.78 against -2.37); a higher nitrate concentration per 100 mL gave a smaller effect, and trials using nitrate-depleted juice as placebo showed a weaker effect than trials with other comparators
• In elite swimmers under race conditions a concentrated dose changed nothing at all. — 12 elite male swimmers, mean age 20, 200 m personal best 115.7 seconds (n = 12) Evidence B source
  No difference in first time trial (116.7 against 117.2 s, p = 0.19), second time trial (117.8 against 117.8 s, p = 0.98) or the change between them (p = 0.40); blood lactate and perceived exertion also unchanged

Safety, limits and interactions

• Drinking enough beetroot juice to move blood pressure can push nitrate intake past the accepted daily limit, and almost nobody has studied what that does. — published literature on beetroot juice, nitrate and nitric oxide Evidence C source
  Beetroot juice can readily raise nitrate intake above the acceptable daily intake, which stimulates endogenous formation of N-nitroso compounds, a class known to be carcinogenic and linked to other adverse effects; the authors record that literature on the negative effects is limited compared with that on benefits
• In dialysis patients a single dose raised blood nitrate higher than in healthy people, and left blood pressure and potassium untouched. — 8 adults on chronic haemodialysis and 7 age-matched healthy volunteers (n = 15) Evidence B source
  Active juice raised plasma nitrate and nitrite in both groups; area under the curve and peak concentration of nitrate, though not nitrite, were significantly higher in dialysis patients than in healthy volunteers; blood pressure and plasma potassium were unaffected in both groups and no adverse events occurred

What people believe that the data does not support

• Nitrate taken as a supplement, with beetroot juice deliberately excluded, did not lower blood pressure at all. — 6 studies with 181 participants, 59% male, over 50 years of age (n = 181) Evidence A source
  Diastolic pressure -2.00 mm Hg (95% CI -4.37 to 0.38), systolic -3.81 (-10.05 to 2.43) and resting heart rate +0.34 bpm (-5.68 to 6.36), none significant; average PEDro score 8.16 indicating low risk of bias

Who this works differently for

• For people who actually have high blood pressure, the review looking only at them concluded there is not enough evidence either way. — 12 papers with 321 participants, 10 randomised trials and 2 quasi-experimental, all with baseline blood pressure above 120/80, some with diabetes or heart failure (n = 321) Evidence C source
  Three different outcome patterns appeared across the studies: no change in either pressure, a fall in both, or a fall in systolic with no change in diastolic; the authors attribute the divergence to age, comorbidities, use of antihypertensives, source and dose of nitrate and follow-up length

The bottom line

For people who actually have high blood pressure, the review that looked only at them concluded there is not enough evidence to support or refute any effect, and listed three different result patterns across twelve studies. For athletes the gains are 1.2 to 5.4 percent in fatigue resistance in about a third of studies, and in elite swimmers under race conditions a concentrated dose changed nothing. The doses in all of this come from 70 mL sports concentrates with 400 mg of nitrate, and no source we have tells you how much nitrate is in a supermarket carton. There is a cost side too: enough juice to move blood pressure can push nitrate intake past the accepted daily limit, and the review that says so also says the data on harm is too thin to weigh properly.

Sources

1. bjc-dr-04 · systematic review
   It seems that a chronic intake of ∼5-6 mmol of NO3- in 70 ml of BRJ, twice a day, for a minimum of 3-6 days could lead to a fatigue resistance improvement during repeated sprints.
   Crit Rev Food Sci Nutr, 2021 · checked 2026-09-22
2. bjc-dr-07 · randomised crossover bioavailability study
   In total, approximately 0.3% of betacyanins (ranging from 0.12 to 0.58%) ingested from both products was excreted.
   Food Res Int, 2018 · checked 2026-09-22
3. bjc-dr-01 · systematic review and meta-analysis of randomised controlled trials
   Overall, SBP (-3.55 mm Hg; 95% CI: -4.55, -2.54 mm Hg) and DBP (-1.32 mm Hg; 95% CI: -1.97, -0.68 mm Hg) were significantly lower in the beetroot juice-supplemented groups than in the control groups.
   Adv Nutr, 2017 · checked 2026-09-22
4. bjc-dr-05 · randomised double-blind crossover trial
   In conclusion, acute BRJ supplementation did not enhance 200-m front-crawl performance, lactate responses, or perceived exertion in elite swimmers under competition-like conditions.
   Int J Sport Nutr Exerc Metab, 2026 · checked 2026-09-22
5. bjc-dr-06 · systematic review
   Compared to studies on the beneficial effects, the amount of data and literature on the negative effects of BRJ is rather limited, and should be increased in order to perform a balanced risk assessment.
   Crit Rev Food Sci Nutr, 2021 · checked 2026-09-22
6. bjc-dr-08 · randomised placebo-controlled crossover kinetics study
   The area under the curve and the maximal concentration of plasma nitrate, but not of nitrite, were significantly higher in HD patients as compared with HV. In both groups, active BJ ingestion did not affect blood pressure or plasma potassium levels.
   Nutrients, 2022 · checked 2026-09-22
7. bjc-dr-02 · systematic review and meta-analysis of randomised controlled trials
   Compared to the placebo condition, NO₃⁻ supplementation did not result in significant reductions in DBP (MD: -2.00 mm Hg; 95% CI: -4.37 to 0.38 mm Hg); SBP (MD: -3.81 mm Hg; 95% CI: -10.05 to 2.43 mm Hg); and RHR (MD: 0.34 bpm; 95% CI: -5.68 to 6.36 bpm).
   Nutr Res, 2026 · checked 2026-09-22
8. bjc-dr-03 · systematic review with narrative synthesis
   There is insufficient evidence to support or refute the use of inorganic nitrate for any effect on blood pressure at this time.
   JBI Database System Rev Implement Rep, 2019 · checked 2026-09-22