Written by: Tomasz Sadowski
This article reviews the clinical evidence for beetroot-derived nitrate supplementation. It is not sponsored by or affiliated with any supplement manufacturer. It is for educational purposes only and is not a substitute for individualised medical advice. Dietary supplements are not regulated as drugs and may vary in content and quality. If you are considering beetroot-nitrate supplementation — particularly if you take blood-pressure medication or other cardiovascular drugs — consult your GP, cardiologist, or pharmacist before starting.
tl:dr
Beetroot nitrate supplements — including products like SuperBeets — have some clinical evidence behind them, but the picture is more nuanced than the marketing suggests:
- Inorganic nitrate from beetroot is converted to nitric oxide in the body, which dilates blood vessels and can modestly lower blood pressure (S1)(S4)(S5).
- Clinical trials show modest systolic blood-pressure reductions (roughly 3–5 mmHg) over weeks — significant statistically, but smaller than what medications achieve (S1)(S2)(S4).
- Exercise-performance benefits are inconsistent: some trials show improved endurance, others show no effect, and results vary by population (S3).
- Beetroot supplements do not replace antihypertensive medications, heart-healthy diets, or cardiovascular risk-factor management (S2)(S5).
- Common side effects include beeturia (red/pink urine) and mild GI upset; people on blood-pressure medications or vasodilators should consult a clinician before starting (S5).
Table of contents
- How do beetroot nitrate supplements work?
- Do beetroot supplements lower blood pressure?
- Do beetroot supplements improve exercise performance?
- How does beetroot juice compare with beetroot powder?
- What are the side effects and safety concerns?
- Can beetroot supplements replace medications or a healthy diet?
- Frequently asked questions
- Sources
Beetroot Nitrate Supplements: What the Evidence Actually Shows
How do beetroot nitrate supplements work?
The nitrate → nitrite → nitric oxide pathway
Beetroot is one of the richest dietary sources of inorganic nitrate. When you consume beetroot — whether as juice, powder, or whole vegetable — the nitrate enters your digestive system and follows a specific biochemical pathway (S4)(S5).
First, bacteria on the tongue reduce dietary nitrate to nitrite. This is not a trivial step — it is why antiseptic mouthwashes that kill oral bacteria can actually blunt the blood-pressure-lowering effect of dietary nitrate, because they interrupt this bacterial conversion (S4). The nitrite is then swallowed, absorbed into the bloodstream, and converted to nitric oxide (NO) through several enzymatic and non-enzymatic pathways, particularly in acidic environments like the stomach and in hypoxic (low-oxygen) tissues (S4)(S5).
Nitric oxide is a potent vasodilator — it relaxes the smooth muscle in blood-vessel walls, causing them to widen and reducing peripheral vascular resistance. This is the same molecule targeted by nitroglycerin (used for angina) and sildenafil-type drugs (used for erectile dysfunction and pulmonary hypertension), though dietary nitrate works through a different and slower pathway (S4)(S5).
The net physiological effect of increased nitric-oxide availability from dietary nitrate is a modest reduction in blood pressure and an improvement in blood-vessel function (endothelial function), which has been documented across multiple clinical settings (S1)(S2)(S4).
What products like SuperBeets contain
SuperBeets is one of several beetroot-powder supplements marketed as concentrated sources of dietary nitrate. It is produced by dehydrating and processing beetroot into a powder that can be mixed with water. The manufacturer claims a standardised nitrate content per serving, though the actual nitrate levels can vary between batches and are not subject to the same regulatory verification as pharmaceutical products (S5).
Other beetroot-nitrate products include concentrated beetroot-juice shots (such as those produced for sports nutrition), beetroot capsules, and beetroot-derived nitrate isolates. The category is broad, and the nitrate content per serving varies significantly between products and formats (S4)(S5). This variability is important when evaluating the evidence, because clinical trials specify the nitrate dose — typically in the range of 200–800 mg inorganic nitrate — and whether a given commercial product delivers that dose depends on its actual nitrate content, not its marketing claims.
Do beetroot supplements lower blood pressure?
What clinical trials have found
The most directly relevant evidence for beetroot-powder supplements comes from randomised, placebo-controlled trials and from meta-analyses of beetroot and inorganic-nitrate supplementation.
A 4-week randomised crossover trial in older adults (mean age ~67 years) using an inorganic-nitrate-rich beetroot powder found modest reductions in systolic and mean arterial blood pressure compared with a nitrate-depleted placebo (S1). The supplement attenuated peripheral chemoreflex sensitivity — a marker of vascular responsiveness — but did not improve cardiovagal baroreflex sensitivity, suggesting that the benefit is primarily vascular rather than a broad autonomic reset (S1).
A separate double-blind, placebo-controlled trial in hypertensive patients demonstrated that daily dietary-nitrate supplementation (beet-derived) lowered blood pressure over 4 weeks, even when participants were already taking standard antihypertensive medications (S2). The effect was additive — meaning it provided a further reduction on top of what the medications were already achieving — not a substitute for the medications themselves (S2). Improvements were linked to enhanced endothelial vascular function (S2).
Meta-reviews and evidence-synthesis chapters pooling data from multiple randomised trials confirm that inorganic-nitrate and beetroot-juice supplementation are associated with a statistically significant reduction in systolic blood pressure (S4). The effects are dose-dependent and more pronounced in hypertensive and older adults than in young, healthy, normotensive individuals (S4).
How large is the effect?
The blood-pressure reduction from beetroot-nitrate supplementation is real but modest. Across studies, the typical systolic reduction is in the range of 3–5 mmHg over several weeks of daily use (S2)(S4). Diastolic reductions are smaller, typically 1–3 mmHg (S4).
To put this in context: first-line antihypertensive medications (such as ACE inhibitors, ARBs, or calcium-channel blockers) typically reduce systolic blood pressure by 8–15 mmHg when used at standard doses. A 3–5 mmHg reduction from a dietary supplement is meaningful at a population level — small reductions in average blood pressure reduce cardiovascular events across large populations — but it is not a substitute for pharmacological treatment in individuals who need it (S2)(S4).
This distinction matters because supplement marketing sometimes implies equivalence with medication. The evidence does not support that claim.
Who benefits most — and who doesn't?
The blood-pressure effect of beetroot nitrate is not uniform across populations. It tends to be larger in (S3)(S4):
Older adults, in whom nitric-oxide bioavailability is naturally declining. Hypertensive individuals, where there is more room for blood-pressure reduction. People with impaired endothelial function.
It tends to be smaller or absent in young, healthy, normotensive individuals with already-optimal vascular function — which is relevant because many supplement purchasers fall into this category (S3)(S4).
A systematic review of 12 randomised trials on older adults found that six showed improvements in blood-pressure and blood-flow parameters after beetroot-nitrate supplementation, while six found no significant effect (S3). This roughly 50/50 split in trial outcomes is important to acknowledge — it means that a meaningful proportion of people who try beetroot supplements may see no measurable blood-pressure benefit.
Do beetroot supplements improve exercise performance?
What systematic reviews show
The exercise-performance question is where the evidence becomes most inconsistent. A systematic review of 12 trials in older adults found that dietary-nitrate-rich beetroot supplementation improved exercise time-to-exhaustion in some studies (S3). The proposed mechanism is that increased nitric-oxide availability improves muscle blood flow and oxygen delivery, potentially reducing the oxygen cost of exercise and delaying fatigue (S3)(S5).
Some individual trials in athletes and recreational exercisers have also reported reduced perceived exertion and improved endurance performance, particularly in activities involving sustained moderate-to-high-intensity effort (S3)(S5).
Where the evidence is inconsistent
Not all trials show benefit. The same systematic review that found positive results in some studies found null results in others — cardiovascular and cerebrovascular outcomes were inconsistent across the evidence base (S3). In specific populations, the evidence is particularly mixed: a meta-analysis in patients with chronic obstructive pulmonary disease (COPD) found that beet-nitrate juice did not significantly change blood pressure, heart rate, VO₂max, or walking endurance (S3).
The reasons for this inconsistency are not fully resolved. They likely include differences in nitrate dose, supplement formulation, baseline nitric-oxide status (people with higher baseline levels may benefit less), fitness level, and the specific exercise test used (S3)(S5). For YMYL purposes, the honest summary is: beetroot-nitrate supplements may modestly improve endurance and reduce perceived exertion in some people, but they are not a reliable performance enhancer for everyone, and they should not be marketed as universal "energy boosters."
How does beetroot juice compare with beetroot powder?
Nitrate content and delivery
Beetroot juice — particularly concentrated "shots" designed for sports and cardiovascular use — can deliver higher concentrations of nitrate and polyphenols per serving than many beetroot powders (S5). This is because juice retains much of the water-soluble nitrate content of the raw vegetable, while the dehydration process used to produce powder can variably affect nitrate levels depending on the processing method.
Beetroot powders, on the other hand, offer practical advantages: longer shelf life, easier portability, and — in products that standardise their nitrate content — more consistent dosing between batches (S5). They may also contain less sugar than juice.
Is one form "better" than the other?
Neither form is categorically superior. The variable that drives the physiological effect is the nitrate dose actually delivered per serving, not the physical format (S4)(S5). A high-nitrate powder delivering 400 mg of inorganic nitrate per serving will produce similar vascular effects to a juice delivering the same dose. A low-nitrate powder or a heavily diluted juice may deliver less.
The practical takeaway for consumers is: compare nitrate content per serving (when available on the label), not just the product name or format. And recognise that supplement labelling for nitrate content is not regulated with the same precision as pharmaceutical dosing — actual content can vary from what is claimed (S5).
What are the side effects and safety concerns?
Common side effects
The most frequently reported side effect of beetroot-nitrate supplementation is beeturia — a harmless red or pink discolouration of urine (and sometimes stool) caused by the betalain pigments in beetroot, not by blood (S5). It occurs in a significant proportion of people who consume concentrated beetroot products and resolves after stopping.
Mild gastrointestinal discomfort — including bloating, gas, and stomach cramps — can also occur, particularly at higher doses or in people not accustomed to high-nitrate foods (S5). These effects are generally transient and manageable by reducing the dose.
Drug interactions
Because nitrate supplements can lower blood pressure, they have the potential to interact with (S2)(S5):
Antihypertensive medications — the additive blood-pressure-lowering effect, while modest, could cause symptomatic hypotension (light-headedness, dizziness) in people already on aggressive blood-pressure therapy. Vasodilators, including phosphodiesterase-5 inhibitors (sildenafil, tadalafil) — combining nitric-oxide-boosting supplements with these drugs can produce excessive vasodilation and a dangerous drop in blood pressure. This is the same pharmacological interaction that makes nitroglycerin and sildenafil a contraindicated combination, and while dietary nitrate is a weaker stimulus, the principle applies.
If you take any medication for blood pressure, heart disease, or erectile dysfunction, consult a clinician or pharmacist before adding a beetroot-nitrate supplement (S2)(S5).
Who should avoid beetroot nitrate supplements
People with a history of kidney stones may want to exercise caution, as beetroot is high in oxalates, which can contribute to calcium-oxalate stone formation (S5). People with hypotension (already-low blood pressure) should be cautious about any product that further lowers blood pressure. And people on anticoagulant therapy should discuss the addition of any new supplement with their prescriber, as nitric-oxide pathways can influence platelet function (S5).
Can beetroot supplements replace medications or a healthy diet?
No — and this is the single most important point in this article.
The clinical trials that showed blood-pressure benefits from beetroot-nitrate supplementation tested the supplement as an add-on to existing medical therapy, not as a replacement for it (S2). The landmark hypertension trial explicitly demonstrated that the effect was additive — participants continued their prescribed antihypertensive medications throughout the study (S2). There is no clinical evidence supporting the withdrawal of prescribed cardiovascular medications in favour of a beetroot supplement.
Long-term cardiovascular-event data for beetroot-nitrate supplementation — whether it actually reduces heart attacks, strokes, or cardiovascular mortality over years — are essentially absent (S5). The existing evidence shows short-term, modest physiological effects (blood-pressure reduction, improved endothelial function, some exercise-performance benefits). Whether these translate into hard clinical outcomes over decades is unknown.
A heart-healthy diet, regular physical activity, smoking cessation, blood-pressure and cholesterol management, and — when needed — prescription medication are the foundations of cardiovascular risk reduction. Beetroot-nitrate supplements may provide a modest additional contribution to this foundation, particularly for blood-pressure management. They do not replace any part of it.
If you are considering beetroot-nitrate supplementation, the most responsible approach is to discuss it with your GP or cardiologist, particularly if you take other medications. Use it as a complement to — not a substitute for — evidence-based cardiovascular care.
Frequently asked questions
Does SuperBeets actually lower blood pressure?
Beetroot-derived nitrate supplements can modestly reduce systolic blood pressure — roughly 3–5 mmHg over several weeks in clinical trials, particularly in older and hypertensive adults (S1)(S2)(S4). This is a real but small effect and does not replace antihypertensive medication. Results vary between individuals (S3).
Is beetroot juice better than beetroot powder for blood pressure?
Juice often delivers higher concentrations of nitrate and polyphenols per serving, but may contain more sugar (S5). Powders offer convenience and consistency. Neither form is clearly superior; the effective variable is the nitrate dose delivered, not the format (S4)(S5).
Does beetroot powder help with exercise performance?
Some trials show improved time-to-exhaustion and reduced perceived exertion, but results are inconsistent (S3). A systematic review found roughly half of trials showed benefit while the other half did not. The effect varies by population and fitness level (S3).
What are the side effects of beetroot supplements?
Beeturia (harmless red/pink urine) and mild GI discomfort are the most common (S5). Beetroot supplements can interact with blood-pressure medications and vasodilators — consult a clinician before starting if you take these drugs (S2)(S5).
Can beetroot supplements replace blood-pressure medication?
No. The blood-pressure benefit was studied as an add-on to standard therapy, not a replacement (S2). Long-term cardiovascular-outcome data are lacking (S5). Do not stop or adjust prescribed medications based on supplement use.
Sources
- [S1] Bock JM, et al. "Inorganic nitrate supplementation attenuates peripheral chemoreflex sensitivity but does not improve cardiovagal baroreflex sensitivity in older adults." Am J Physiol Heart Circ Physiol, 2018;314(1):H45–H51. PMID: 28971842.
- [S2] Kapil V, et al. / Bondonno CP, et al. "Dietary Nitrate Provides Sustained Blood Pressure Lowering in Hypertension." Hypertension, 2015;65(2):320–327. DOI: 10.1161/HYPERTENSIONAHA.114.04675.
- [S3] "Performance and Health Benefits of Dietary Nitrate Supplementation in Older Adults: A Systematic Review." Nutrients, 2017;9(11):1171. PMID: 29077028.
- [S4] NCBI evidence-synthesis chapter on inorganic nitrate and beetroot juice supplementation. https://www.ncbi.nlm.nih.gov/books/NBK138056/.
- [S5] Clifford T, et al. "The Potential Benefits of Red Beetroot Supplementation in Health and Disease." Nutrients, 2015;7(4):2801–2822. PMC4425174.
