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Beetroot and nitrates for runners: what's being used and what the research says

We report what runners are using and what the research says. We don't recommend taking any supplement. Talk to your GP or a registered sports dietitian before trying one.

Quick answer

Research suggests the effect is small. Nitrate, usually taken as beetroot juice, extended time to exhaustion in meta-analyses but didn't clearly improve time trials, the tests closest to racing[1]. A meta-analysis found no benefit in well-trained endurance athletes[2], and an expert consensus concluded that effects appear smaller in very fit people[3].

Research
Emerging (proposed)Longer time to exhaustion in lab tests. Little effect on time trials or in very fit runners.
Proposed by our editor; not yet confirmed by an expert reviewer.
WADA status
Permitted
Distances in the research
800 m–5K: studied10K–half: limited researchMarathon: not studiedUltra: not studied

What is beetroot juice?

Nitrate is a compound found naturally in vegetables such as beetroot and leafy greens[4], and about 80% of the nitrate in the diet comes from vegetables[5]. Levels vary widely: EFSA reports median levels from 1 mg/kg in peas and Brussels sprouts to 4,800 mg/kg in rocket[6]. Studies report doses in millimoles (mmol); 8 mmol is about 500 mg[3].

Most studies have given nitrate as beetroot juice; some used nitrate salts[3]. Running trials have used beetroot juice drinks of 70 to 210 ml[7][8], 500 ml a day of beetroot juice[9], 420 ml a day of unprocessed juice[10], 200 g of baked beetroot[11] and potassium nitrate[12]. The placebo was usually beetroot juice with the nitrate removed[13][7].

Products differ. In a lab analysis of 24 beet juice products, nitrate varied about 50-fold between products, batches of the same product varied too, and only 5 products consistently gave at least 5 mmol a serving[14]. Storage matters: in a study cited by EFSA, the nitrate in industrially produced beetroot juice fell when it was kept for 48 hours at room temperature, and fell less in the fridge[6].

The Australian Institute of Sport puts dietary nitrate and beetroot juice in Group A of its supplement framework, meaning strong scientific evidence for use in specific situations in sport[15].

Also called: beetroot juice, beet juice, dietary nitrate, beetroot shots.

Why is beetroot juice getting attention?

Nitrate is one of the few supplements the IOC consensus statement says has good evidence behind it[16], and the international athletics federation's 2019 consensus lists it among the evidence-based supplements for athletics[17]. It is also heavily researched: a 2025 umbrella review found 20 meta-analyses covering 180 studies and 2,672 participants[1].

Relatively few people use it. In a survey of 1,404 active people in Australia, where running was the most common exercise, 11.9% had ever taken nitrate, most often as beetroot juice. Most users had one to three servings a week, and over half said it gave them more energy (54.8%) or better performance (50.3%)[18].

The claims, checked against the research

  • Faster race timesMixed

    Time trials, the lab tests closest to racing, showed no significant improvement overall[1]. In running trials, 1,500 m got faster in two[13][19] but not in elite runners[8], and two 5 km trials found no difference[7][12].

  • Lasting longer at a hard paceSupported

    Meta-analyses found that nitrate extended time to exhaustion, a lab test of how long people can keep going[20][1]. In 9 active men, 6 days of beetroot juice extended it by 15% in hard treadmill running[9].

  • Using less oxygen at the same paceMixed

    An expert panel agreed that several days of nitrate reduces oxygen use in steady exercise[3], as seen in active men[9]. Running economy didn't change in elite runners[8][21] or highly trained skiers[12].

  • Running feels easierMixed

    Effort ratings were lower partway through a 5 km run after baked beetroot[11] and likely improved in elite runners after 15 days[21], but didn't change in well-trained runners at simulated altitude[22].

  • An edge for well-trained runnersMixed

    A meta-analysis found no effect in athletes with a VO2peak of 65 ml/kg/min or more[2], and an expert consensus concluded that effects appear smaller above 60[3]. Elite 1,500 m runners saw no difference[8]. But in a small trial in 12 elite distance runners, 15 days of beetroot juice gave likely gains in time to exhaustion on a treadmill[21].

  • Better performance at altitudeMixed

    At a simulated 2,500 m, nitrate made a 1,500 m time trial 3.2% faster[19] but didn't change a 10 km time trial[22]. Across studies, the oxygen level of the air breathed didn't change the size of the effect[2].

  • Faster recovery after long racesNot supported

    After a marathon, 3 days of beetroot juice didn't change muscle function, soreness or muscle-damage markers[23]. An observational ultra study linked beetroot to better blood markers but can't show cause[24].

  • Better marathon and ultra timesNot studied

    We found no controlled trials of marathon or ultra performance; the longest race distance tested in the running trials we found was 10 km[10][25].

How does beetroot juice work?

The body can make nitric oxide in two ways: from the amino acid arginine, and from nitrate in food, which is converted to nitrite and then to nitric oxide[1]. Nitric oxide can lower the oxygen cost of steady exercise and help muscles contract[4].

The first step relies on bacteria in the mouth, which convert nitrate to nitrite; nitrite is then reduced to nitric oxide, particularly when oxygen is low or conditions are acidic[1]. Because of this detour through the mouth, nitrite in the blood peaks about 2 to 3 hours after nitrate is taken, 1 to 2 hours after nitrate itself peaks[3]. In one study, stronger antibacterial mouthwashes cut the rise in nitrite after beetroot juice[26].

The effect comes from the nitrate rather than other compounds in beetroot. In a trial in active men, beetroot juice lowered the oxygen cost of running, but the same juice with the nitrate removed did not[9].

Why fitter people seem to benefit less is not settled. The umbrella review's authors think a ceiling effect is likely, with very fit people having less room to improve. Another suggestion is that well-trained people already have higher nitrate levels, because training increases nitric oxide made from arginine; a third, that athletes eat more nitrate, has been challenged[1].

Does beetroot juice improve running performance?

Sometimes, and mostly in lab tests. Across 20 meta-analyses covering 180 studies, nitrate extended time to exhaustion, but time trials, the tests closest to racing, showed no significant improvement[1]. The overall effect is small, and it was absent in well-trained endurance athletes[2]. Running trials are small and split: some found faster 1,500 m times[13][19], while others found no change at 1,500 m, 5 km or 10 km[8][7][10].

800 m to 5K (Studied)

Most running trials sit here. In 8 trained male runners and triathletes, beetroot juice made a 1,500 m treadmill time trial about 2% faster[13]. In 12 men at a simulated altitude of about 2,500 m, a 1,500 m time trial was 3.2% faster, and all 12 improved[19]. In 8 elite 1,500 m runners it made no difference, after one dose or after 8 days[8].

At 5 km, the results are mostly null. In 70 recreational runners racing 5 km, a smaller dose of about 4 mmol made no difference compared with a placebo[7], and potassium nitrate didn't change a 5 km running time trial in 10 highly trained junior cross-country skiers[12]. In 11 recreationally fit adults, baked beetroot 75 minutes before a 5 km treadmill run made the last 1.8 km 5% faster, though the overall pace difference wasn't significant[11].

Lab measures moved more often than race times. After 6 days of beetroot juice, 9 active men lasted 15% longer in hard treadmill running[9], and 3 days slightly raised VO2max and peak treadmill speed in 13 recreational runners[27]. These are lab tests, not races.

10K to half marathon (Limited research)

Three small trials at 10 km found no significant difference: in trained runners[13], in recreational runners after three days of beetroot juice[10], and in well-trained runners at simulated altitude[22]. In the recreational runners, the first 5 km was faster with beetroot juice and 10 of 14 finished faster, but the overall difference of about 1 minute wasn't significant[10].

In a 4-week study of 16 recreational runners training three times a week, 10 km times improved with both nitrate and placebo; only the nitrate group also improved between weeks 1 and 2, and its blood lactate stayed lower[25]. We found no controlled trials at the half marathon.

Marathon (Not studied)

We found no controlled trials of marathon performance. An expert panel felt unable to make a general statement about whether nitrate helps in any specific activity[3].

One trial looked at recovery instead. In 34 experienced marathon runners, 3 days of beetroot juice after the race didn't change muscle function, soreness, inflammation or muscle-damage markers compared with a placebo[23].

Ultra (Not studied)

We found no controlled trials in ultra running. The longest race distance tested in the running trials we found was 10 km[10][25].

An observational study of 32 runners in a 107 km ultra-trail race found that the 6 who reported taking beetroot during the race had more favourable blood markers of oxidative stress and muscle damage at the finish and over the next two days. Nobody was assigned to take beetroot, so it can't show cause and effect[24].

Study by study

The main studies on this page. What they took is what the study gave, not advice for any individual.
StudyWho took partWhat they tookWhat was measuredWhat they found
Poon 2025 [1]Meta-analysis20 meta-analyses of 180 studies (2,672 participants)Nitrate v placebo, many doses and durationsTime to exhaustion, time trials and other testsTime to exhaustion improved (SMD 0.33), more with at least 6 mmol a day for over 3 days. Time trials did not (SMD −0.03). Most reviews low or critically low quality
Senefeld 2020 [2]Meta-analysis80 placebo-controlled crossover studies (randomised or counterbalanced) in young, healthy adultsNitrate v placebo, many doses and durationsExercise performance, all tests pooledSmall benefit (d = 0.17), clearest in recreationally active men. Not significant in athletes with a VO2peak of 65 ml/kg/min or more, or in 6 studies of women only
McMahon 2017 [20]Meta-analysis47 studies (76 trials) in healthy adultsNitrate v placeboTime trials, time to exhaustion and graded exercise testsTime to exhaustion improved (small to moderate effect). Time trials and graded tests: no significant effect
Shannon 2017 [13]Randomised controlled trial8 trained male runners and triathletes140 ml concentrated beetroot juice (about 12.5 mmol) or nitrate-depleted juice, 3 hours before1,500 m and 10,000 m treadmill time trials1,500 m about 2% faster (320 v 326 s). No significant difference over 10,000 m
Boorsma 2014 [8]Randomised controlled trial8 elite male 1,500 m runners (VO2peak about 80 ml/kg/min)210 ml beetroot juice (19.5 mmol) or placebo, tested on days 1 and 8 of daily dosing. Randomised crossoverOxygen use while running; 1,500 m time trial on an indoor trackNo change in oxygen use or 1,500 m time (about 4:10). Two runners improved
Hurst 2020 [7]Non-randomised trial70 recreational runners70 ml beetroot shot (about 4.1 mmol) or nitrate-depleted placebo, 2.5 hours before. Quasi-randomised, double-blindCompetitive 5 km time trialsNo difference from placebo (0.8 s). Both were about 22 s faster than baseline runs
de 2019 [10]Randomised controlled trial14 male recreational runners420 ml unprocessed beetroot juice (8.4 mmol) or placebo daily for 3 days, the last 2 hours before. Crossover10 km runNo significant difference (50.1 v 51.0 min); the first 5 km was faster
Arnold 2015 [22]Randomised controlled trial10 well-trained male runners (VO2max about 66 ml/kg/min)About 7 mmol of nitrate or placebo, 2.5 hours beforeTest to exhaustion at simulated 4,000 m; 10 km treadmill time trial at simulated 2,500 mNo significant change in either (10 km: 2,862 v 2,874 s)
Lansley 2011 [9]Randomised controlled trial9 healthy, active men500 ml beetroot juice a day (about 6.2 mmol) or nitrate-depleted juice for 6 days. CrossoverOxygen cost of walking and running; time to exhaustion in hard treadmill runningLower oxygen cost. Time to exhaustion 15% longer (8.7 v 7.6 min)
Wylie 2013 [28]Randomised controlled trial10 healthy men70, 140 or 280 ml concentrated beetroot juice (4.2, 8.4 or 16.8 mmol) or placebo, 2.5 hours beforeBlood nitrite; cycling time to task failureNitrite peaked at 2 to 3 hours. 8.4 and 16.8 mmol: 14% and 12% longer. 4.2 mmol: no effect
Shannon 2016 [19]Randomised controlled trial12 healthy men, VO2max 47 to 77 ml/kg/min138 ml concentrated beetroot juice (about 15.2 mmol) or placebo, 3 hours before1,500 m treadmill time trial at a simulated 2,500 m3.2% faster (331 v 342 s). All 12 improved, with no link to fitness
Peacock 2012 [12]Randomised controlled trial10 male junior cross-country skiers (VO2max about 70 ml/kg/min)Potassium nitrate (614 mg of nitrate) or placebo, 2.5 hours before5 km running time trial on an indoor trackNo significant difference (1,005 v 996 s)
Murphy 2012 [11]Randomised controlled trial11 recreationally fit men and women200 g baked beetroot (at least 500 mg nitrate) or cranberry relish, 75 minutes before5 km treadmill time trialOverall pace not significantly faster; last 1.8 km 5% faster
Balsalobre-Fernández 2018 [21]Randomised controlled trial12 elite middle and long-distance runnersBeetroot juice or placebo daily for 15 days, 6 runners per groupIncremental treadmill test to exhaustionLikely gains in effort ratings and time to exhaustion; no meaningful change in running economy or VO2max

The key studies, in order

  1. 2009Expert reviewAbout 80% of dietary nitrate comes from vegetables; a high-nitrate diet pattern exceeded the acceptable daily intake by 550% for a 60 kg adult. [5]
  2. 2011Trial9 active men, 6 days of beetroot juice v nitrate-depleted juice: lower oxygen cost of walking and running, and 15% longer time to exhaustion running. [9]
  3. 2012Trial11 recreationally fit adults, 200 g of baked beetroot 75 minutes before a 5 km run: overall pace not significantly faster, but the last 1.8 km was 5% faster. [11]
  4. 2012Trial10 highly trained junior cross-country skiers: potassium nitrate 2.5 hours before did not change a 5 km running time trial or the oxygen cost of running. [12]
  5. 2013Non-randomised trial19 healthy volunteers: a week of chlorhexidine mouthwash cut nitrite made in the mouth by 90% and raised blood pressure by 2 to 3.5 mmHg. [37]
  6. 2013Trial10 healthy men: blood nitrite peaked 2 to 3 hours after beetroot juice; 8.4 and 16.8 mmol extended cycling time to task failure, but 4.2 mmol did not. [28]
  7. 2014Trial8 elite 1,500 m runners: neither one dose nor 8 days of beetroot juice changed 1,500 m time-trial performance, though two runners improved. [8]
  8. 2015Trial10 well-trained runners at simulated altitude: about 7 mmol of nitrate 2.5 hours before did not change 10 km time-trial time or time to exhaustion. [22]
  9. 2016Trial12 men at a simulated altitude of about 2,500 m: about 15.2 mmol of nitrate 3 hours before made a 1,500 m treadmill time trial 3.2% faster. [19]
  10. 2016Trial12 men drank beetroot juice: stronger antibacterial mouthwashes cut the rise in nitrite in blood and saliva. Performance was not tested. [26]
  11. 2017Trial34 marathon runners, beetroot juice or placebo for 3 days after the race: no difference in muscle function, soreness, inflammation or muscle damage. [23]
  12. 2017Meta-analysis47 studies: nitrate improved time to exhaustion (a small to moderate effect) but had a trivial, non-significant effect on time trials. [20]
  13. 2017Trial8 trained male runners and triathletes: about 12.5 mmol 3 hours before made a 1,500 m treadmill time trial about 2% faster, but made no difference over 10,000 m. [13]
  14. 2018Trial12 elite distance runners, 15 days of beetroot juice or placebo: likely gains in effort ratings and time to exhaustion, but no meaningful change in running economy. [21]
  15. 2018Expert reviewNitrate from food becomes nitric oxide in the body, which can lower the oxygen cost of steady exercise and improve how muscles contract. [4]
  16. 2018ConsensusNitrate is among the few performance supplements with good evidence. Contamination is a known anti-doping risk of supplement products. [16]
  17. 2018Trial8 well-trained cyclists at 35°C, about 8 mmol a day for 3 days: no change in 4 km time-trial power; rectal temperature was a trivial 0.1°C higher than with placebo. [36]
  18. 2019ConsensusEvidence-based supplements for athletics include caffeine, bicarbonate, beta-alanine, nitrate and creatine, with value specific to each event. [17]
  19. 2019Trial14 recreational runners, 3 days of beetroot juice (8.4 mmol a day): no significant difference in 10 km time, though the first 5 km was faster. [10]
  20. 2019Trial13 male recreational runners, 3 days of beetroot juice v placebo: slightly higher VO2max and peak treadmill speed. [27]
  21. 2019Observational study24 beet juice products tested: nitrate varied about 50-fold between products, and only 5 consistently gave at least 5 mmol a serving. [14]
  22. 2019Trial24 healthy adults aged 60 to 70, a month of a nitrate-rich salad and citrulline drink v placebo: maximal cycling power up 5.2%, mean blood pressure down 3.3 mmHg. [30]
  23. 2019Trial16 recreational runners training for 30 days with about 12 mmol of nitrate a day or placebo: 10 km times fell in both groups. [25]
  24. 2019Trial12 recreationally active women, about 26 mmol a day for 1 or 8 days: no change in oxygen use or cycling time-trial performance. [32]
  25. 2020Non-randomised trial70 recreational runners racing 5 km: a 70 ml shot with about 4 mmol of nitrate, 2.5 hours before, made no difference compared with a placebo. [7]
  26. 2020Meta-analysis80 placebo-controlled studies: a small overall benefit, clearest in recreationally active young men. No significant effect in well-trained endurance athletes or in the six studies of women alone. [2]
  27. 2022Consensus12 experts agreed that 8-16 mmol taken 2-4 hours before exercise is ergogenic; the authors concluded that effects look smaller above a VO2peak of 60 ml/kg/min and that vegetables and their juices may be the safest source. [3]
  28. 2023Survey1,404 active Australians: 11.9% had used nitrate, most often as beetroot juice; 4.5% of users reported side effects such as red urine, red stools or stomach upset. [18]
  29. 2023Trial12 women and 14 men, 3 days of beetroot juice: oxygen cost fell about 5% and time to exhaustion rose about 15% in the men, but neither changed in the women. [31]
  30. 2024Trial15 postmenopausal women aged 50 to 65, 8 days of beetroot juice: 19.6 m further in a 6-minute walk; strength, agility and balance unchanged. [29]
  31. 2024Trial10 naturally menstruating women, about 13 mmol a day for about 5 days: lower calculated maximal power and velocity; muscular endurance unchanged. [33]
  32. 2024Observational study32 ultra-trail runners: the 6 who reported beetroot use during the race had more favourable blood markers of oxidative stress and muscle damage afterwards. Observational, so it can't show cause. [24]
  33. 2025Meta-analysisTrials in healthy women aged 18 to 30: a small-to-moderate gain in muscle power, but no significant effect on strength or sprinting. [34]
  34. 2025Meta-analysis20 meta-analyses of 180 studies: longer time to exhaustion, more so with at least 6 mmol a day for over 3 days, but no significant improvement in time trials. [1]

Who has the research been done in?

Most of the research was done in young men, and the clearest benefit in an 80-study meta-analysis was in recreationally active young men[2].

Fitness matters. An expert panel agreed that nitrate helped people with a VO2peak below 45 ml/kg/min, and below 60 when taken for several days; its report concluded that effects appear smaller above 60[3]. The running trials were small, with 8 to 70 participants each[8][7].

Older people are less studied. The panel said there wasn't enough evidence to know whether effects differ with age: some but not all studies of over-60s found benefits, and many included people with health conditions[3]. In a pilot trial of 15 postmenopausal women aged 50 to 65, 8 days of beetroot juice added 19.6 m to a 6-minute walk but didn't change strength, agility or balance[29]. In adults aged 60 to 70, a drink combining nitrate-rich salad with citrulline raised maximal cycling power by 5.2%, so nitrate's own share can't be separated[30].

What we know about women

Women are under-represented, making up 7 to 37% of participants in the meta-analyses that reported it[1]. In an 80-study meta-analysis, the six studies of women alone found no significant effect, though the authors thought this likely spurious because so few studies included women[2]. An expert panel said there isn't enough evidence to know whether women respond differently, and noted that researchers have proposed physiological reasons why the effect could be smaller in women[3].

Recent trials point the same way. When 12 women and 14 men took beetroot juice for 3 days, the men used about 5% less oxygen during moderate exercise and lasted about 15% longer to exhaustion, but the women, tested early in the menstrual cycle, did not[31]. In 12 recreationally active women using hormonal contraceptives, a high dose of about 26 mmol a day for 1 or 8 days didn't change oxygen use or a cycling time trial[32]. In 10 naturally menstruating women, nitrate lowered calculated maximal power and velocity regardless of cycle phase and didn't change muscular endurance[33].

A meta-analysis of trials in women aged 18 to 30 found a small-to-moderate gain in muscle power, but no significant effect on strength or sprinting, with low to moderate certainty[34].

What the research can't tell us yet

The meta-analyses themselves are weak: of the 20 in the umbrella review, 12 were rated critically low for quality, 6 low and 2 moderate[1]. An expert panel agreed the positive results mostly come from lab trials with too few participants, performance tests only partly like real competition, and only partial checks on things such as mouthwash use and habitual diet[3].

Much is simply unknown: the same panel reached agreement on only 39 of 222 statements (17.6%) and judged the evidence insufficient for 134 (60.4%)[3].

Individual responses vary. Some highly trained athletes may respond, but few studies were designed to identify responders, and blood levels of nitrate products vary a lot within the same person[3]. In elite 1,500 m runners, 2 of 8 improved[8]; at altitude, 3 of 10 well-trained runners likely improved[22].

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How and when is beetroot juice used in studies?

An expert panel agreed the performance effects in studies came from single doses of 8 to 16 mmol of nitrate (about 500 to 1,000 mg), taken 2 to 4 hours before exercise, or from 4 to 16 mmol a day over several days[3]. It agreed that single doses below 4 mmol did not work, and put a single dose at roughly 2 to 4 beetroot shots, depending on the product[3].

Dose matters up to a point. In 10 healthy men, 70 ml of concentrated juice (4.2 mmol) did not change responses to cycling, while 140 ml (8.4 mmol) and 280 ml (16.8 mmol) extended time to task failure by 14% and 12%, with no extra gain from the larger dose[28]. For scale, a 70 ml shot in one running trial contained about 4 mmol[7], and running trials went up to 19.5 mmol in 210 ml of juice[8].

In the umbrella review, time to exhaustion improved more with at least 6 mmol (372 mg) a day for more than three days[1]. The expert panel agreed that beetroot juice and nitrate salts both worked in studies, found too little evidence for nitrate sports drinks, gels or chewing gum, and couldn't agree on whether nitrate-rich vegetables work[3].

When studies gave it

Single doses were usually taken 2 to 4 hours before exercise. An expert panel agreed that nitrate taken less than 90 minutes, or 6 to 8 hours, before a test did not improve performance[3]; blood nitrite peaks about 2 to 3 hours after a dose[28]. Running trials gave it 3 hours[13][19], 2.5 hours[7][22][12] or 2 hours before[10]. The baked beetroot trial was an exception, at 75 minutes[11].

Other studies gave nitrate every day: for 3 days[10], 6 days[9], 8 days[8], 15 days[21] or 30 days alongside training[25]. For daily use, the expert panel's report put the final dose 2 to 4 hours before exercise[3]. Across the meta-analyses, time to exhaustion improved more with more than three days of at least 6 mmol a day[1].

Real-world use doesn't always match the studies. In the Australian survey, 42.1% of users took nitrate immediately before exercise, and only 14.3% of participants knew of the 2 to 3 hour window[18].

What studies used. These are research protocols, not advice for any individual.
What studies usedWhenRef.
8 to 16 mmol of nitrate (about 500 to 1,000 mg) in one dose2 to 4 hours before exercise[3]
4 to 16 mmol of nitrate a day for several daysFinal dose 2 to 4 hours before exercise[3]
At least 6 mmol (372 mg) a day for more than 3 daysLinked to larger gains in time to exhaustion[1]
4.2, 8.4 or 16.8 mmol in 70, 140 or 280 ml of concentrated juice2.5 hours before; 4.2 mmol had no effect[28]
About 6.2 mmol a day in 500 ml of beetroot juice for 6 daysTests on days 4 and 5[9]
About 12.5 mmol of nitrate in 140 ml of concentrated beetroot juice3 hours before a 1,500 m or 10,000 m time trial[13]

What are the side effects, and who should be careful?

Side effects were uncommon in a survey of active Australians: 7 of 154 users (4.5%) reported any, mostly pink or red urine, red stools or stomach upset, with single reports of nausea, headache and light-headedness[18]. The NHS notes that beetroot can turn pee pink, but says anyone who thinks they have blood in their pee needs to get it checked[35].

An expert panel agreed that nitrate doesn't raise the risk of methaemoglobinaemia, a rare blood disorder, or of low blood pressure, and that a single dose doesn't raise cancer risk; its report applies these findings to doses up to about 16 mmol a day. It couldn't agree on cancer risk from long-term use. It found no evidence of harm from nitrate-rich foods and juices, couldn't agree on nitrate salts, gels, drinks or gum, and said athletes may be better off getting nitrate from vegetables and vegetable juices. Single doses up to about 16 mmol are believed to be safe[3].

The panel also agreed that nitrate doesn't raise the risk of heat illness during exercise above 30°C[3]; in 8 well-trained cyclists at 35°C, rectal temperature was 0.1°C higher with nitrate than with placebo, which the authors rated as trivial[36].

EFSA keeps an acceptable daily intake (ADI) of 3.7 mg of nitrate per kg of body weight a day, and estimates that, counting all foods, it would be exceeded in all age groups at average and high intakes. It judged that even at the highest rate of conversion to nitrite in saliva, the methaemoglobin formed would not be clinically significant, and its contaminants panel concluded that the benefits of eating vegetables prevail[6]. A vegetable-rich diet can pass the ADI several times over[5]; so can doses in performance studies, and the expert panel agreed the ADI isn't appropriate on current evidence[3].

Medicines and health conditions

Antibacterial mouthwash can blunt the first step of nitrate metabolism: in 12 men given beetroot juice, stronger mouthwashes cut the rise in nitrite in saliva and blood[26]. In 19 healthy volunteers who took no nitrate supplement, a week of chlorhexidine mouthwash cut nitrite made in the mouth by 90% and raised blood pressure by 2 to 3.5 mmHg[37].

In one trial in healthy active men, systolic blood pressure was 124 mmHg after 6 days of beetroot juice, compared with 129 mmHg on a nitrate-depleted placebo[9]. An expert panel agreed that nitrate does not raise the risk of low blood pressure, at doses up to about 16 mmol a day[3].

Nitrate medicines are a different matter. The NHS says sildenafil is not usually prescribed together with nitrates, and tells people who take nitrates such as GTN for chest pain to ask a pharmacist or doctor[38]. It also says there isn't enough information to say herbal remedies are safe to take with GTN[39]. We found no NHS guidance on beetroot juice alongside these medicines.

Be careful if

  • You use antibacterial mouthwash: stronger mouthwashes cut the rise in nitrite after beetroot juice[26].
  • You take nitrate medicines such as GTN: the NHS says sildenafil is not usually prescribed with them, and we found no guidance on beetroot juice[38].
  • You have low blood pressure or take blood pressure medicines: beetroot juice lowered blood pressure in healthy men[9].
  • You're considering nitrate salts, gels or gum: an expert panel couldn't agree on their side effects[3].
  • You have a sensitive stomach: stomach upset is among the side effects users report[18].
  • Your pee turns red or pink: beetroot can do this, but the NHS says possible blood in pee needs checking[35].

Is beetroot juice allowed in competition?

Nitrate is not on the World Anti-Doping Agency's Prohibited List[40]. An expert panel agreed that using it doesn't break the spirit of sport or give an unfair advantage[3].

The anti-doping risk with any supplement product is contamination: products can contain prohibited substances that aren't on the label, and athletes are responsible for anything found in their sample[16].

Independent quality-assurance schemes, often called batch testing, check supplement products for prohibited substances[16]. WADA says using a product from one of these schemes can reduce, but not eliminate, the risk of an anti-doping violation[40], and the IOC says no product can be guaranteed entirely safe[16].

Myth or evidence?

5 things runners hear about beetroot juice. Pick an answer to see what the research says.

  1. 1.Beetroot juice makes every runner faster.

    Show the answer

    Myth. Time trials showed no significant improvement across 20 meta-analyses[1], and a meta-analysis found no effect in well-trained endurance athletes[2].

  2. 2.Nitrate can help you keep going for longer in lab tests.

    Show the answer

    Evidence. Meta-analyses found nitrate extended time to exhaustion[1][20].

  3. 3.Very fit runners tend to get less from nitrate.

    Show the answer

    Evidence. An expert consensus concluded that effects appear smaller in people with very high aerobic fitness, a VO2peak above 60 ml/kg/min[3].

  4. 4.Mouthwash can interfere with how the body uses nitrate.

    Show the answer

    Evidence. In one study, stronger antibacterial mouthwashes cut the rise in nitrite after beetroot juice[26].

  5. 5.Beetroot juice is banned in competition.

    Show the answer

    Myth. Nitrate is not on the WADA Prohibited List[40].

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Frequently asked questions

Does beetroot juice improve running performance?
Research suggests a small effect at most. Across 20 meta-analyses, nitrate extended time to exhaustion in lab tests, but time trials showed no significant improvement[1].
How long before a run do studies give beetroot juice?
Usually 2 to 4 hours before. An expert panel agreed that less than 90 minutes, or 6 to 8 hours, before didn't improve performance[3].
Does beetroot juice work for well-trained runners?
Less so. A meta-analysis found no effect in well-trained endurance athletes[2], and an expert consensus concluded that effects appear smaller when VO2peak, a measure of aerobic fitness, is above 60 ml/kg/min[3].
Does mouthwash stop beetroot juice working?
It may interfere. Bacteria in the mouth convert nitrate, and in one study stronger antibacterial mouthwashes cut the rise in nitrite after beetroot juice. Performance wasn't tested[26].
Can beetroot juice turn your urine pink?
Yes. Pink or red urine was among the side effects users reported[18]. The NHS notes that beetroot can turn pee pink, but says possible blood in pee needs checking[35].
Is beetroot juice banned in athletics?
No. Nitrate is not on the WADA Prohibited List[40]. Supplement products can still be contaminated with substances that are[16].
How much nitrate is in a beetroot shot?
It varies. A 70 ml shot in one running trial had about 4 mmol[7], and across 24 products nitrate varied about 50-fold; only 5 consistently gave at least 5 mmol a serving[14].
Does beetroot juice help in a marathon?
Nobody knows yet. We found no controlled trials of marathon performance, and an expert panel felt unable to say whether nitrate helps in any specific activity[3].
Is it better to drink beetroot juice for a few days before a race?
In lab tests, several days may help more: time to exhaustion improved more with at least 6 mmol a day for more than three days[1]. In elite 1,500 m runners, 8 days made no difference[8].
Does beetroot juice work for women?
It's unclear. Six studies of women alone found no significant effect[2], and when men and women took the same juice, the men improved but the women did not[31].
Is beetroot juice safe?
Single doses up to about 16 mmol are believed to be safe, but long-term safety needs more research, according to an expert panel[3]. EFSA's contaminants panel concluded that estimated exposures to nitrate from eating vegetables are unlikely to pose appreciable health risks[6].
Is eating beetroot as good as drinking the juice?
Nobody knows for sure. An expert panel couldn't agree on whether nitrate-rich vegetables help, though it saw no reason they couldn't if they provide enough nitrate[3]. In one small trial, baked beetroot made the last 1.8 km of a 5 km run faster[11].
Does beetroot juice help at altitude?
The evidence is mixed. At a simulated 2,500 m, it made a 1,500 m time trial 3.2% faster in one trial[19] but didn't change a 10 km time trial in another[22].

References

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    Observational study32 ultra-trail runners: the 6 who reported beetroot use during the race had more favourable blood markers of oxidative stress and muscle damage afterwards. Observational, so it can't show cause.

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    RegulatorEating beetroot can turn pee pink; anyone who thinks they have blood in their pee needs to get it checked.

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    RegulatorNames medicines for erection problems such as sildenafil, and says there isn't enough information to say herbal remedies are safe to take with GTN.

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    www.wada-ama.org/en/prohibited-list

Who wrote and reviewed this

Written by Grant MacMillan, Editor, RunV. Not yet reviewed by an expert.

Last checked against its references . Next review due . How pages are reviewed · How we grade research

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