Beetroot Juice Benefits: 3.5 mmHg Off Blood Pressure. More Nitrate Made It Work Less.
Beetroot juice lowers blood pressure. Across 22 randomised trials, systolic pressure came down 3.55 mmHg and diastolic 1.32. [1] Longer trials did more. Bigger glasses did more.
So this is not a debunk, and we are not going to pretend it is.
It is a story about why it works — because the answer appears not to be the ingredient on the label.
| What was tested | Systolic blood pressure |
| Beetroot juice · 22 trials | −3.55 mmHg |
| Sodium nitrate alone · 6 trials | no significant change |
| Juice with MORE nitrate per 100 mL | smaller effect, not larger |
| Exercise performance · 80 trials | d = 0.174 |
More nitrate made it work less
Beetroot is sold on nitrate. Nitrate becomes nitrite, nitrite becomes nitric oxide, nitric oxide opens up blood vessels. That is the pitch, and it is on every bottle and every gummy.
Inside the same meta-analysis, the reviewers checked whether juices with more nitrate produced bigger effects. They found the opposite: “a smaller effect size of blood pressures was observed after supplementation with higher NO3.” [1]
More of the active ingredient, less of the effect. That is not how an active ingredient behaves.
And when they took the nitrate out, the juice still worked
Some of these trials used a clever control: beetroot juice with the nitrate stripped out. Same drink, same colour, same everything, minus the thing supposedly doing the work.
If nitrate were the mechanism, beetroot juice should have crushed that placebo. Instead the measured gap got smaller — −3.09 mmHg against nitrate-free beetroot, versus −4.51 against other placebos. [1]
The reviewers’ own conclusion is that the results “highlight its potential NO3-independent effects”. [1] Something in beetroot is lowering blood pressure. On this evidence, it is not only the nitrate.
We are not going to tell you what it is instead. Betalains are the usual suggestion and we have not read that literature. An honest gap beats a confident guess.
The isolated nitrate, tested on its own, did nothing
Which brings us to a 2026 meta-analysis that tested exactly that: sodium nitrate supplements, with beetroot juice trials deliberately excluded. [3]
Six trials, 181 people, all over fifty. Systolic pressure: no significant change. Diastolic: no significant change. Resting heart rate: no significant change. [3] And this was a clean piece of work — the trials scored low for risk of bias.
Six trials is not many, and the authors say so. But put it beside the juice result and the pattern is hard to miss: the whole drink does something, the isolated compound does not.
On performance, the number is smaller than you think
Now the athletic claim. Eighty randomised crossover trials, sifted from 2,033 candidates. Nitrate did improve exercise performance, and the result was highly statistically significant. [2]
The effect size was 0.174.
Effect size is a way of asking how big a difference is, stripped of what was being measured. Roughly: 0.8 is what researchers call large, 0.5 is moderate, and 0.2 is barely there. This one is 0.174 — below barely there. The reviewers say it plainly: “the effect size of NO3 supplementation was objectively small.” [2]
And it was missing in the two groups most likely to buy it
The subgroup results are where this gets uncomfortable for the category.
In studies of women only, the effect was not observed. Six studies, and the range of plausible answers ran from −0.126 to +0.358 — comfortably including nothing. [2]
In well-trained endurance athletes, the effect was not observed. Twenty-six studies, effect size 0.021, which is indistinguishable from zero. [2] The reviewers note it has “more limited utility… in participants with excellent aerobic fitness that have optimized other training parameters.”
Read that again, because it inverts the marketing. The people buying beetroot shots to shave seconds off a race are the group it did not show up in. It showed up in recreationally active young men — and even there, barely.
While we are here: the mouthwash thing
You may have been told never to use antibacterial mouthwash near your beetroot, because bacteria in your mouth do the first step of converting nitrate.
A 2025 randomised pilot tested it. Antibacterial mouthwash for seven days did reduce the proportion of nitrite in saliva. But breath nitric oxide did not change, and peak torque, maximum velocity and power in the knee extensors were all unaffected. [4]
Thirty people, one type of mouthwash, and the authors call it a pilot. It does not settle the question. It does mean the advice is being passed around with more confidence than the evidence currently carries — which is the same problem as the nitrate claim, pointed the other way.
The verdict
Supported, for the blood pressure claim. Twenty-two randomised trials, a consistent direction, a dose-response relationship, and about 3.5 mmHg off systolic pressure. That is modest and it is real.
Not supported: that nitrate is why. More nitrate produced smaller effects, nitrate-free beetroot performed nearly as well as the real thing, and isolated nitrate supplements moved nothing across six clean trials.
And the performance claim is real but tiny — and absent in women and in trained athletes, which between them describe most of the people the shots are aimed at.
If you like beetroot juice, the evidence is on your side. If you are buying a nitric oxide capsule for the nitric oxide, the trials that isolated it did not find what the label promises.
Blood pressure is a clinical matter. A 3.5 mmHg average across trials is not a treatment plan, and anyone managing hypertension should be having that conversation with a doctor rather than a juice.
Related: creatine for women · do you need electrolytes · fish oil vs krill oil · how much protein to build muscle · every claim we’ve checked
