Das Nitrat in Rote Bete und Blattgemüse wird durch Bakterien auf der Zunge zu Nitrit und anschließend zu Stickstoffmonoxid umgewandelt, dem Molekül, das die Blutgefäße entspannt. Eine konzentrierte Dosis, in der Regel Rote-Bete-Saft, senkt den Blutdruck um einige Punkte und verbessert die Ausdauer durch eine geringere Sauerstoffkosten bei körperlicher Belastung leicht.
Der blutdrucksenkende Effekt ist geringer, wenn der Saft nur zu einer normalen Ernährung hinzugefügt wird, und der sportliche Vorteil lässt bei Spitzensportlern nach.
Findings & Outcomes
What It Is
The nitrate that matters here is inorganic nitrate, and vegetables are its richest source. Beetroot and six nitrate-dense leaves carry the most: rocket, spinach, chard, lettuce, celery, and beet greens. Eat them and the body's store of nitric oxide rises, the signaling molecule that widens blood vessels and eases the heart's work. Vegetable nitrate becomes nitric oxide only after mouth bacteria act on it.
Most trials used beetroot juice: it packs a repeatable dose into one small glass, and a large salad of nitrate-rich leaves reaches the same amount.
What It Does
Dietary nitrate lowers blood pressure and cuts the oxygen cost of exercise, the blood-pressure evidence is stronger. The blood-pressure effect is largest in the people with the most to gain. Someone with high blood pressure sees the biggest, most durable drop, while someone already in the normal range sees little. In a large Danish cohort, a moderate intake of nitrate-rich vegetables tracked with about 15% lower cardiovascular disease. That 15% comes from a whole way of eating, not vegetable nitrate alone.
The exercise effect is smaller and narrower. After a few days of dietary nitrate the same easy-to-moderate effort costs less oxygen, so the body makes energy more efficiently. The clearest gain is endurance, holding a hard effort longer before exhaustion, while a timed finish changes less. The benefit is largest in recreational athletes and often absent in the elite, whose physiology is already efficient. The benefit plateaus: past about 140 ml of concentrated juice, more nitrate adds little.
The Research & Studies
Everything here is based on the research we have collected and checked, sorted into groups and ordered with the strongest evidence first. Click any claim to open the studies behind it.
Heart And Vascular
A single glass of beetroot juice dropped blood pressure up to 10.4/8 mmHg within hours
A single large glass of beetroot juice dropped blood pressure by up to about 10/8 mmHg a few hours later in healthy people, and the size of the drop matched how much the blood's nitrite rose.
About three hours after a single 500 mL dose of beetroot juice, blood pressure fell by up to 10.4/8 mm Hg in healthy volunteers, tracking the peak rise in plasma nitrite. The dose also protected the endothelium against an ischemic insult and reduced platelet aggregation. Measured in: Healthy volunteers in a mechanistic crossover study. A single-dose acute study in healthy volunteers with a small sample, measuring peak change, not a sustained average. Interrupting the mouth's conversion of nitrate to nitrite abolished the effect, confirming the pathway but also showing how easily it is switched off.
The study · 1
Webb et al., acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite · Hypertension 2008;51(3):784-790
Daily beetroot juice held 24-hour blood pressure 7.7/5.2 mmHg lower in hypertension
People with high blood pressure who drank beetroot juice every day for four weeks held their blood pressure several points lower than placebo, and the effect did not fade over the month.
In 68 patients with hypertension, four weeks of daily dietary nitrate (250 mL beetroot juice) versus nitrate-free placeholder juice lowered 24-hour ambulatory blood pressure by 7.7/5.2 mm Hg and clinic pressure by 7.7/2.4 mm Hg, improved endothelial function by about 20%, and reduced arterial stiffness, with no tachyphylaxis and good tolerability. Measured in: 68 adults with hypertension, half drug-naive and half already treated. A single four-week trial of 68 people; durable, but not yet extended to hard outcomes like heart attack or stroke.
The study · 1
Kapil et al., dietary nitrate provides sustained blood pressure lowering in hypertensive patients, a randomized, phase 2, double-blind, placebo-controlled study · Hypertension 2015;65(2):320-327
Pooled across 16 trials, nitrate lowered systolic blood pressure about 4.4 mmHg
Across sixteen trials, nitrate and beetroot juice lowered the top blood-pressure number by about 4 mmHg on average, with a smaller change in the bottom number that was not statistically clear.
Pooling 16 randomized crossover trials with 254 participants, inorganic nitrate and beetroot juice supplementation lowered systolic blood pressure by 4.4 mm Hg (95% CI -5.9 to -2.8). Diastolic pressure fell by 1.1 mm Hg, which did not reach significance (95% CI -2.2 to 0.1). Measured in: 254 participants across 16 randomized crossover trials. The included trials were short and used crossover designs, and the effect on diastolic pressure was not statistically significant. The authors called for long-term trials and studies in higher-risk groups.
The study · 1
Siervo et al., inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults, a systematic review and meta-analysis · J Nutr 2013;143(6):818-826
Added to a normal diet, beetroot juice did not lower whole-day blood pressure
When a single beetroot juice was simply added to the normal diet of healthy people, whole-day blood pressure did not fall clearly, with a real drop showing up only in the men and only around six hours after drinking it.
In 30 free-living healthy adults, a single 500 g dose of beetroot and apple juice did not significantly lower 24-hour blood pressure versus placebo (a trend to lower systolic pressure at 6 hours, P = 0.064). A significant reduction of 4 to 5 mm Hg at 6 hours appeared only in the men after adjustment. Measured in: 15 women and 15 men, free-living healthy adults. A single-dose crossover in already-healthy people with normal blood pressure, where less room to fall and a normal background diet both blunt the signal. It argues that the food works best as a daily habit and in people with raised pressure.
The study · 1
Coles et al., effect of beetroot juice on lowering blood pressure in free-living, disease-free adults, a randomized, placebo-controlled trial · Nutr J 2012;11:106
Six weeks of beetroot juice improved artery function about 24%
In people with high cholesterol, six weeks of beetroot juice measurably improved how well their arteries widened, a marker of blood-vessel health, while placebo did not.
In people with high cholesterol, six weeks of once-daily nitrate-rich beetroot juice versus nitrate-depleted placebo raised flow-mediated dilatation by 1.1 percentage points in absolute terms, about a 24% improvement from baseline, while the placebo group worsened slightly. Measured in: 69 people with untreated high cholesterol (67 completed), parallel-group design. A single six-week trial measuring a surrogate marker of vessel function, not clinical events, in a specific group with high cholesterol.
The study · 1
Velmurugan et al., dietary nitrate improves vascular function in patients with hypercholesterolemia, a randomized, double-blind, placebo-controlled study · Am J Clin Nutr 2016;103(1):25-38
Moderate vegetable-nitrate intake tracked with 15% lower cardiovascular disease
In a large Danish study, people who ate a moderate amount of nitrate-rich vegetables had about 15% lower risk of heart disease than those who ate the least, and slightly lower blood pressure, with no extra gain from eating far more.
Among 53,150 people in the Danish Diet, Cancer, and Health Study, a moderate vegetable nitrate intake (median 59 mg/day) was associated with 15% lower risk of cardiovascular disease versus the lowest intake (HR 0.85, 95% CI 0.82-0.89), with the benefit plateauing near that intake. The highest-intake group had 2.58/1.38 mm Hg lower baseline blood pressure. Measured in: 53,150 Danish adults free of cardiovascular disease at baseline. What could explain it instead: People with higher vegetable nitrate intake tend to eat a healthier overall diet, exercise more, smoke less and be of higher socioeconomic status; residual confounding from the whole dietary and lifestyle pattern cannot be separated from vegetable nitrate itself.. This is an association, not proof of cause. People who eat more vegetables plateauing at a modest intake tend to differ in ways the study cannot fully remove.
The study · 1
Bondonno et al., vegetable nitrate intake, blood pressure and incident cardiovascular disease, Danish Diet, Cancer, and Health Study · Eur J Epidemiol 2021;36(8):813-825
Cardiorespiratory Fitness
Three days of dietary nitrate cut the oxygen cost of submaximal exercise about 5%
After three days of dietary nitrate, well-trained men used measurably less oxygen for the same easy-to-moderate cycling, meaning their bodies produced energy more efficiently.
In a randomized double-blind placebo-controlled crossover, three days of dietary sodium nitrate lowered the oxygen cost of submaximal cycling: mean VO2 fell from 2.98 to 2.82 L/min, about 5%, across the four lowest work rates and gross efficiency rose from 19.7% to 21.1%, with no rise in blood lactate. Measured in: 9 healthy, well-trained young men. A small crossover of nine men using a nitrate salt, not food, at a single dose; the economy gain is small in absolute terms.
Who this may not transfer to:The study enrolled only men. Whether the oxygen-economy effect is the same size in women has not been tested here, and sex differences in nitric-oxide handling are not fully characterized.
The study · 1
Larsen et al., effects of dietary nitrate on oxygen cost during exercise · Acta Physiol (Oxf) 2007;191(1):59-66
Beetroot juice lowered exercise oxygen cost 19% and extended time to exhaustion to 675 seconds
Six days of beetroot juice let men do moderate exercise on less oxygen and hold a hard effort noticeably longer before exhaustion, while also lowering their blood pressure.
In eight men, six days of beetroot juice (500 mL/day) versus placebo raised plasma nitrite, lowered systolic blood pressure (124 vs 132 mmHg), reduced the oxygen uptake of moderate exercise by about 19%, and extended time to exhaustion during severe exercise from 583 to 675 seconds. Measured in: 8 healthy men aged 19-38, crossover design. A small crossover of eight men; the time-to-exhaustion measure exaggerates real-world performance changes compared with a timed event.
Who this may not transfer to:Eight men only. The economy and tolerance effects have not been measured in women in this study, and endurance-physiology research in this area is heavily male-skewed.
The study · 1
Bailey 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 (1985) 2009;107(4):1144-1155
Across 76 trials, nitrate improved time-to-exhaustion (effect size 0.33) but not timed events
Pooling many trials, dietary nitrate reliably helped people last longer in hold-a-hard-effort tests, but its effect on overall performance and on timed events was small and not statistically clear.
Across 47 studies (76 trials), dietary nitrate had a small-to-moderate significant benefit on time-to-exhaustion tests (effect size 0.33, 95% CI 0.15-0.50) but only a trivial, non-significant effect overall (ES -0.10) and a small non-significant effect on graded exercise tests. The benefit is clearest for endurance capacity, not timed performance. Measured in: 76 trials in healthy adults. The benefit is specific to time-to-exhaustion protocols, which overstate real-world gains; the overall pooled effect was not significant, and elite athletes tend to respond least.
The study · 1
McMahon et al., the effect of dietary nitrate supplementation on endurance exercise performance in healthy adults, a systematic review and meta-analysis · Sports Med 2017;47(4):735-756
Beetroot juice raised power in 4-km and 16.1-km cycling time trials
A dose of beetroot juice before a cycling time trial let trained male cyclists produce more power and finish faster.
In nine club-level competitive male cyclists, acute beetroot juice versus placebo raised plasma nitrite and increased mean power output during 4-km and 16.1-km cycling time trials, improving performance even though VO2 during the trials did not differ significantly. Measured in: 9 club-level competitive male cyclists. A small single-dose study in nine trained male cyclists; effects on timed performance are smaller and less consistent than effects on time to exhaustion, and often shrink in more elite athletes.
Who this may not transfer to:Only male cyclists were tested. Performance effects in female athletes were not measured here.
The study · 1
Lansley et al., acute dietary nitrate supplementation improves cycling time trial performance · Med Sci Sports Exerc 2011;43(6):1125-1131
The oxygen-cost benefit plateaus around 140 ml of beetroot juice
In a dose test, a small beetroot shot did little, a moderate dose lowered the oxygen cost of exercise, and doubling that dose again added nothing, so more is not better past a point.
In 10 healthy men given 70, 140 or 280 mL of beetroot juice, 140 and 280 mL reduced the steady-state oxygen uptake of moderate exercise but 70 mL did not, and there was no additional benefit from the highest dose over the middle one, indicating a ceiling around 140 mL (about 8 mmol nitrate). Measured in: 10 healthy men, balanced crossover. Ten men in a single crossover; the exact ceiling dose likely varies with body size and training status.
Who this may not transfer to:Ten men only. The dose-response curve has not been mapped in women, who differ in body size and plasma volume.
The study · 1
Wylie et al., beetroot juice and exercise, pharmacodynamic and dose-response relationships · J Appl Physiol (1985) 2013;115(3):325-336
How it works
Antibacterial mouthwash removes most of the blood-nitrite rise after a nitrate load
Rinsing with an antibacterial mouthwash kills the tongue bacteria that turn nitrate into nitrite, so the usual rise in the blood's nitrite after eating nitrate largely disappears.
The rise in plasma nitrite that normally follows a dietary nitrate load was markedly attenuated by an antibacterial mouthwash, which removes the commensal tongue bacteria that reduce nitrate to nitrite, interrupting the first step of the pathway. Measured in: Healthy volunteers in a mechanistic study. A small mechanistic study measuring the nitrite step, not a health outcome; it establishes the mechanism that the blood-pressure studies then confirmed downstream.
The study · 1
Govoni et al., the increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash · Nitric Oxide 2008;19(4):333-337
Three days of antibacterial mouthwash raised systolic blood pressure 2.3 mmHg
In people already treated for high blood pressure, just three days of antibacterial mouthwash nudged their systolic blood pressure up by about 2 mmHg, showing how much the body relies on the mouth's nitrate-handling bacteria.
In 15 treated hypertensive men and women (mean age 65), three days of antibacterial mouthwash use raised systolic blood pressure by 2.3 mm Hg (95% CI 0.5 to 4.0, P = 0.01) versus control, with no significant change in diastolic pressure, by interrupting the oral nitrate-nitrite-nitric oxide pathway. Measured in: 15 treated hypertensive men and women, mean age 65. A small crossover of 15 people over three days; the effect is small, but it points the same direction as the mechanistic work and is a practical reason to keep antibacterial mouthwash away from a nitrate habit.
The study · 1
Bondonno et al., antibacterial mouthwash blunts oral nitrate reduction and increases blood pressure in treated hypertensive men and women · Am J Hypertens 2015;28(5):572-575
How It Works
About a quarter of swallowed nitrate is drawn back up into the saliva, where bacteria on the back of the tongue, the oral microbiome, reduce it to nitrite. That nitrite is swallowed again. In the stomach and the blood it turns onward into nitric oxide, mainly where tissue is low on oxygen and a widened vessel helps. This is the nitrate–nitrite–nitric oxide pathway, one of the body's two routes to it. The other starts from the amino acid arginine.
That first step needs living mouth bacteria, so anything that kills them removes the effect.
An antibacterial mouthwash does exactly that, and the usual nitrite rise after a nitrate load largely vanishes.
In people treated for high blood pressure, three days of mouthwash raised systolic pressure by about 2 mmHg.
Nitric oxide also cuts the energy a muscle spends to contract. The biggest savings come from two sources: more efficient mitochondria and a lower cost per contraction. Better blood flow adds a smaller share. That is why the same food that eases blood pressure also lets a person hold a pace on less oxygen.
Ways to Do It
This is a food first. The free version is a plate of nitrate-rich vegetables; the paid version is a measured, repeatable dose in a small volume. A useful dose is about 5 to 8 mmol of nitrate. That is a 70 to 140 ml shot, 250 to 500 ml of juice, 300 to 500 g of beetroot, or a big serving of rocket or spinach. Blood pressure begins to fall within two to three hours of a dose and builds over days of daily intake. For exercise, take a dose two to three hours before.
Build meals around the leafy greens and beetroot: a large rocket or spinach salad, chard, beet greens, cooked or grated beetroot. A generous daily serving reaches the range the trials used, and it brings the fiber, potassium, and polyphenols of the whole vegetable.
A glass of beetroot juice, plain or blended with apple to soften the earthiness, delivers a known amount in one small volume.
The shot is the most repeatable dose and the one exercise studies used. Consistent and convenient.
If you are eating nitrate for your heart, keep antibacterial mouthwash well away from the hours around a dose. It removes the tongue bacteria the whole pathway needs.
Go Deeper
- The oral microbiome: the tongue bacteria that turn this nitrate into a blood-pressure signal, and why antiseptic mouthwash blunts it.
- High blood pressure: where a few millimeters from food sits among the levers that lower it.
- VO2 max training: the endurance training dietary nitrate makes slightly easier to sustain.
- Sodium reduction and the DASH pattern: the dietary changes that lower blood pressure alongside nitrate-rich vegetables.
- Whole foods: the eating pattern that already carries a daily load of nitrate-rich leaves.
Cautions For This Practice
Everything to be aware of is here, in one place. This practice suits most healthy people; a few situations call for real care.
The vegetable nitrate pathway does not carry the processed-meat cancer risk
Inorganic nitrate and nitrite, long regarded as inert end-products or as undesirable, are now understood as a physiological reservoir the body reduces to nitric oxide, with emerging therapeutic interest in myocardial infarction and stroke. This reframes vegetable nitrate as a source of a signaling molecule, not a contaminant. This is a review setting out the pathway and its promise, not a trial of safety endpoints; the historical infant methemoglobinemia concern and the separate question of nitrite in processed meats sit outside the vegetable-nitrate picture it describes.Lundberg et al., the nitrate-nitrite-nitric oxide pathway in physiology and therapeutics
Red urine or stool from beetroot is harmless
Beetroot pigment can tint urine and stool pink or red for a day. It is called beeturia and it is the color passing through, not bleeding. It is common and it clears on its own, so it does not need attention unless it persists. Blood in urine or stool from another cause is a separate matter and should be checked, not put down to beetroot.
If you take blood-pressure medication, keep an eye on your numbers
Dietary nitrate lowers blood pressure, and added to medication that does the same it can lower it further, occasionally enough to cause light-headedness on standing. Track your own blood pressure with a home monitor, available without a prescription. If it runs low or you feel dizzy, raise it with your prescriber before stopping anything on your own.
A history of calcium-oxalate kidney stones is a reason to go easy
Beetroot, spinach and chard are high in oxalate, and a large daily habit, especially from concentrated shots, adds a meaningful oxalate load. If you have formed calcium-oxalate stones, favor the lower-oxalate nitrate sources such as rocket, lettuce and celery, keep fluids up, and moderate the beetroot and spinach.
The nitrate-cancer worry comes from processed meat
The old worry that dietary nitrate causes cancer grew from nitrite added as a preservative to cured and processed meat. During cooking and storage that nitrite can combine with the meat's fats and proteins to form nitrosamines. Vegetable nitrate arrives with vitamin C and polyphenols that shift the chemistry the other way, and large vegetable-nitrate intakes track with lower cardiovascular risk.
Start slow, be smart, read the research, and consult a professional if you have any concerns. This is here to inform your choice, not make it for you.
Common Questions
How much does beetroot juice lower blood pressure?
Pooled across sixteen trials, the average systolic drop is about 4 mmHg, modest on a single reading but a real shift when a whole population eats this way.
How long does the effect last?
In people with high blood pressure, a daily glass held it several points lower over 30 days, with no fade.
Explore Related
Other pages this one connects to, by the evidence they share, the outcomes they touch, and the ground they cover.
All 14 sources on this page independently checked and cross-referenced.
Thomas Dehli, Founder & Editor, Sacred Lotus
Sacred Lotus has published Chinese medicine reference material since 2001. Integrative pages are held to the same standard as the herb and formula library: cite the source, grade the claim at its real strength, and say where the research has not looked. This page is educational and it is not medical advice. Last reviewed and updated August 9, 2026.
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