Beetroot Research

Dietary Nitrate Supplementation and Exercise Performance: An Umbrella Review of 20 Published Systematic Reviews with Meta-analyses

Senefeld JW et al. • Sports Medicine (2025)

Dietary nitrate supplementation benefits exercise performance across multiple meta-analyses.

• 8.3-16.4 mmol (515-1017 mg) nitrate recommended
• Acute and chronic supplementation both effective
• More effective under hypoxic conditions or fatigue

Effects of Beetroot Juice on Physical Performance in Professional Athletes and Healthy Individuals: An Umbrella Review

Wang Y et al. • Nutrients (2025)

Professional athletes showed muscular strength benefits while non-athletes had aerobic endurance improvements.

• Population-specific effects identified
• Muscular strength benefits in athletes (SMD=0.27)
• Aerobic endurance improvements in non-athletes (SMD=0.26)

Efficacy and safety of dietary polyphenol supplements for COPD: a systematic review and meta-analysis

Wu D et al. • Frontiers in immunology (2025)

This systematic review confirms that the efficacy of dietary polyphenols is significantly composition-specific.

• This systematic review confirms that the efficacy of dietary polyphenols is significantly composition-specific.
• Curcumin and salidroside can improve the course of COPD by regulating blood pressure, inflammation, and the coagulation pathway, supporting the hypothesis of "polyphenol targeting of metabolic-inflammatory networks".
• However, the possible negative effects of anthocyanins warn against ingredient heterogeneity.

Effects of Beetroot-Based Supplements on Muscular Endurance and Strength in Healthy Male Individuals: A Systematic Review and Meta-Analysis

Evangelista JF et al. • Journal of the American Nutrition Association (2024)

BRS administration have a small ergogenic effect on muscular endurance and attenuate the decline in muscular strength in a fatigued state in healthy male individuals.

• Meta-analyses and subgroup analyses of standardized mean differences (SMD) were performed using a random-effects model.
• BRS administration resulted in a positive effect on muscular endurance (SMD: 0.31; 95% confidence interval (CI): 0.10 to 0.51; p < 0.01; n = 16 studies).
• Of those, 27 studies attended eligibility criteria and composed this systematic review.

Effects of dietary supplements on athletic performance in elite soccer players: a systematic review

Abreu R et al. • Journal of the International Society of Sports Nutrition (2023)

Still, more well-designed research with elite soccer players is needed to improve support and advice regarding the use of dietary supplements for athletic performance enhancement.

• Nitrate-rich beetroot concentrate can attenuate performance decrease in the days following matches.
• Further investigation with sodium bicarbonate alone is necessary, as supplementation protocols with elite players included other substances.
• Finally, the available data does not support yohimbine supplementation or the use of Resurgex Plus® to improve athletic performance in elite soccer players.

Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults: A Systematic Review with Meta-Analyses and Meta-Regressions

Silva KVC et al. • Advances in nutrition (Bethesda, Md.) (2022)

Published by Oxford University Press on behalf of the American Society for Nutrition.

• To assess the variation in effect size, we used meta-regression models for continuous variables and subgroup analysis for categorical variables.
• An inverse dose-response relation between the fraction of inspired oxygen and the effect size (coefficient: -0.045, 95% CI: -0.085, -0.005, P = 0.028) suggests that nitrate was more effective in increasingly hypoxic conditions.
• The most effective acute dose was between 5 and 14.9 mmol provided ≥150 min prior to exercise (P <0.001).

Effects of Nitrate Supplementation on Muscle Strength and Mass: A Systematic Review

Anderson OK et al. • Journal of strength and conditioning research (2022)

This SUP regime seems to improve muscle efficiency in terms of reduced phosphocreatine and energy costs (P-magnetic resonance spectroscopy) and improved time to exhaustion.Copyright © 2021 National Strength and Conditioning Association.

• Of the 12 studies, 6 observed an ergogenic effect of SUP compared with placebo.
• These findings indicate that muscle strength gains are possible provided the dose, format, frequency, period, and exercise test are appropriate.
• Best results were observed with a minimum acute dose of 400 mg of nitrate provided as beetroot juice/shot taken 2-2.5 hours before exercise involving low- and high-intensity muscle contractions.

Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-analysis

Senefeld JW et al. • Medicine & Science in Sports & Exercise (2020)

Exercise performance improved with nitrate supplementation compared with placebo.

• 80 eligible studies analyzed
• Significant performance improvement (d=0.174)
• More effective in hypoxic conditions

Effects of beetroot juice on blood pressure in hypertension according to European Society of Hypertension Guidelines: A systematic review and meta-analysis

Grönroos R et al. • Nutrition, metabolism, and cardiovascular diseases : NMCD (2024)

Daily ingestion of 200-800 mg of nitrate from BRJ may reduce clinical systolic BP in hypertensive individuals with no sign of development of tolerance.

• Daily ingestion of 200-800 mg of nitrate from BRJ may reduce clinical systolic BP in hypertensive individuals with no sign of development of tolerance.
• Certainty of evidence is low, and results should be interpreted with caution.
• Further research warranted to confirm findings

Impact of beetroot juice on oxidative stress in untrained individuals: A systematic review and meta-analysis.

Ponce-Dávila EO, Neder-Suarez D, Carrasco-Legleu CE, Hernández-Torres RP, Acosta-Carreño RE, Benítez-Hernández ZP • Nutr Health (2026)

Sport supplementation in competitive swimmers: a systematic review with meta-analysis

Domínguez R et al. • Journal of the International Society of Sports Nutrition (2025)

Creatine supplementation demonstrated ergogenic benefits for competitive swimmers, although the evidence supporting the use of this supplement is still limited.

• This revision included 23 studies, 16 of them (69.6%) qualified as excellent and 7 (30.4%) as good at the methodological level based on the punctuation in the PEDro scale.
• The systematic review included 422 swimmers (61.8% male, 38.2% female), with distances assessed ranging from 50 m to 800 m, including studies employing interval procedures.
• Creatine showed a significant effect (ES = -0.46; 95% CIs = -0.75 to -0.17, p = 0.002; I2 = 11%) on swimming performance, while the rest of the analyzed supplements did not show significant effects (all p > 0.05).

Systematic Review of the Effects of Plant-Based Foods on Metabolic Outcomes in Adults with MASLD and Comorbidities Such as Obesity, Metabolic Syndrome, and Type 2 Diabetes

Jurek JM et al. • Nutrients (2025)

Further research is needed to validate these effects and ensure their safety in MASLD management.

• Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become one of the most prevalent liver diseases, affecting up to 40% of adults and strongly associated with obesity and metabolic dysfunction.
• Liver enzymes improved following consumption of WGPs, BJ, sour tea, flaxseed oil, and garlic, and hepatic steatosis was reduced after intake of oranges, WGPs, HFBs, BJ, flaxseed powder, rapeseed oil, and garlic powder.
• Conversely, a solely fruit-rich diet (FRD) had negative effects across all outcomes.

Effect of Caffeine and Nitrates Combination on Exercise Performance, Heart Rate and Oxygen Uptake: A Systematic Review and Meta-Analysis

Gilsanz L et al. • Nutrients (2024)

CAF+nitrates did not offer further benefits on exercise performance or physiological variables from the isolated intake of CAF and nitrates.

• The meta-analysis revealed that caffeine and nitrates supplementation (CAF+nitrates) did not enhance performance in time trials (TTs) over the CAF alone (g = -0.06; 95% CI = -0.46 to 0.35; p = 0.78) or nitrates alone (g = 0.29; 95% CI = -0.12 to 0.70; p = 0.17).
• CAF+nitrates did not affect heart rate during submaximal exercise trials over CAF alone (g = 0.04; 95% CI = -0.31 to 0.40; p = 0.80) or nitrates alone (g = -0.15; 95% CI = -0.50 to 0.20; p = 0.40).
• Likewise, CAF+nitrates did not affect oxygen uptake during submaximal exercise trials over CAF alone (g = -0.04; 95% CI = -0.45 to 0.37; p = 0.84) or nitrates alone (g = -0.29; 95% CI = -0.70 to 0.12; p = 0.16).

The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis

Bahadoran Z et al. • Advances in nutrition (Bethesda, Md.) (2017)

Our results demonstrate the blood pressure-lowering effects of beetroot juice and highlight its potential NO3-independent effects.© 2017 American Society for Nutrition.

• 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.
• In contrast, a smaller effect size of blood pressures was observed after supplementation with higher NO3 (milligrams per 100 mL beetroot juice).
• A weak effect size was observed in a meta-analysis of trials that used NO3-depleted beetroot juice as a placebo compared with other interventions (-3.09 compared with -4.51 mm Hg for SBP and -0.81 compared with -2.01 mm Hg for DBP).

The Effect of Nitrate-Rich Beetroot Juice on Markers of Exercise-Induced Muscle Damage

Clifford T et al. • Journal of Dietary Supplements (2021)

Beetroot juice accelerated isometric strength recovery 72h post-exercise.

• Accelerated strength recovery (SMD=0.54)
• Improved countermovement jump recovery
• Benefits for exercise-induced muscle damage

Potential Effects of Bioactive Compounds of Plant-Based Foods and Medicinal Plants in Chronic Kidney Disease and Dialysis: A Systematic Review

Josa E et al. • Nutrients (2024)

These results suggest that bioactive compounds of plant-based foods and medicinal plants have promising effects in terms of preventing or treating CKD progression and appear to improve inflammation and antioxidant capacity and support cardiovascular benefits and renoprotective effects; however, it is recommended that further studies be carried out.

• Systematic review examining Astragalus efficacy
• Published in Nutrients (2024)
• Further research warranted to confirm findings

Effects of Dietary Nitrate Supplementation on High-Intensity Cycling Sprint Performance in Recreationally Active Adults: A Systematic Review and Meta-Analysis

Tan R et al. • Nutrients (2024)

Future studies are required to provide insight on how supplementation regimen and population impact the effects of dietary nitrate for enhancing cycling sprint performance.

• A random effects model was performed on six studies and showed that dietary nitrate had significant effects on time-to-peak power (SMD: -0.66, 95% CI: -1.127 to -0.192, p = 0.006) but not on mean power, peak power, or minimum power.
• Subgroup analysis revealed that an acute low nitrate dose improved time-to-peak power (SMD: -0.977, 95% CI: -1.524 to -0.430, p < 0.001) but not after a multiday moderate nitrate dose (SMD: -0.177, 95% CI: -0.619 to -0.264, p = 0.431).
• These data suggest that acute nitrate supplementation can benefit time-to-peak power during 30-s cycling sprints, but due to the limited availability of data and heterogeneity in methodology, these results should be interpreted with caution.

Dietary Supplementation on Physical Performance and Recovery in Active-Duty Military Personnel: A Systematic Review of Randomized and Quasi-Experimental Controlled Trials

Harlow J et al. • Nutrients (2024)

Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters.

• Nutrition supplementation may have small benefits on muscle performance and recovery in warfighters.
• However, there are significant limitations in interpretation due to the largely inconsistent evidence of ingredients and comparable outcomes.
• Thus, there is inadequate practical evidence to suggest how dietary supplementation may affect field performance.

Dietary nitrate supplementation and exercise performance: A meta-analysis

McMahon NF et al. • Sports Medicine (2017)

Dietary nitrate supplementation improves endurance exercise performance, particularly time to exhaustion.

• Significant improvement in time to exhaustion
• Effects on time trials less consistent
• Greater effects in recreational vs elite athletes

The effects of beetroot and nitrate supplementation on body composition: a GRADE-assessed systematic review and meta-analysis

Afrisham R et al. • The British journal of nutrition (2023)

This meta-analysis study suggests that BR or nitrate supplements cannot efficiently ameliorate body composition indices regardless of supplement dosage, trial duration and athletic status.

• Subgroup analyses based on trial duration, BR or nitrate dose, study design, baseline BMI and athletic status (athlete v. non-athlete) demonstrated similar results.
• Certainty of evidence across outcomes ranged from low to moderate.
• This meta-analysis study suggests that BR or nitrate supplements cannot efficiently ameliorate body composition indices regardless of supplement dosage, trial duration and athletic status.