Beetroot Extract: The Supplement That Improves Endurance, Blood Flow, and Blood Pressure

In the supplement market for athletes, most products promise a lot and deliver little. But once every few years, a supplement comes along that truly passes the lab test. Nitrate-rich beetroot extract is one of those rare cases: not a sophisticated molecule produced in a lab, but a concentrate of a simple root vegetable, which controlled studies have proven improves endurance performance, increases blood flow, and lowers blood pressure simultaneously.

The story began in 2009, when a group of researchers from the University of Exeter in the UK discovered something surprising: drinking beetroot juice before exercise reduced the amount of oxygen the body consumed to perform the exact same work. In other words, the body became more efficient. Since then, dozens of studies have confirmed the finding, making dietary nitrate from beetroot one of the most researched supplements in the sports world.

What is Nitrate-Rich Beetroot Extract?

Beetroot extract is a concentrated concentrate of the red beet, providing a high amount of Dietary Nitrate in a small dose. Here is the main point in brief:

• The active ingredient is nitrate (NO3), a natural ion found in high concentrations in beets, spinach, arugula, and Swiss chard.
• The body converts nitrate to Nitric Oxide, a signaling molecule that dilates blood vessels and improves flow.
• The effective dose is based on nitrate content, typically 6 to 13 millimoles of nitrate per serving, not on the volume of juice.
• Timing is critical: the dose is consumed about 2-3 hours before exercise, when blood nitric oxide levels peak.
• Concentrated extract saves volume: instead of drinking half a liter of beetroot juice, a small extract dose is sufficient.

The importance of beetroot extract is that it provides a consistent and measurable dose of nitrate, without the sugar and volume of regular beetroot juice.

The Mechanism: From Nitrate to Nitric Oxide

The magic of beetroot lies in a biochemical pathway called the nitrate-nitrite-nitric oxide pathway. When we consume nitrate from beets, bacteria in the oral cavity convert it to nitrite. The nitrite is absorbed into the blood, and under conditions of exertion and low oxygen, it is converted to nitric oxide, one of the most important molecules in the vascular system.

Nitric oxide does several things simultaneously:

• Dilates blood vessels, thereby increasing blood flow and oxygen to active muscles.
• Reduces the oxygen cost of muscle contraction, so the muscle produces more power from the same amount of oxygen.
• Improves mitochondrial efficiency, the energy factories of the cell, especially in fast-twitch muscle fibers (Type II).
• Lowers blood pressure, because vasodilation reduces the resistance the heart must overcome.

This is why beetroot extract works on two fronts simultaneously: it is gold for both the athlete looking to improve endurance and the person managing high blood pressure. Both benefits stem from the exact same molecular mechanism.

Current Evidence

Study 1: Benedict Bailey, University of Exeter, 2009

The groundbreaking study published in the journal Journal of Applied Physiology. Subjects drank 500 ml of beetroot juice per day (about 5.1 mmol nitrate) for 6 days. The results were dramatic: the oxygen cost of low-intensity exercise decreased by about 5%, and importantly, time to exhaustion in high-intensity exercise was significantly extended. This was the first proof that a simple dietary component could improve the body's efficiency at the fundamental level of oxygen consumption.

Study 2: Catherine Lansley and colleagues, controlled cycling trial, 2011

In a study published in Medicine & Science in Sports & Exercise, cyclists drank 500 ml of beetroot juice with 6.2 mmol nitrate about 2.5 hours before a time trial. The result: a 2.8% improvement in 4 km cycling performance, and a 2.7% improvement in 16.1 km performance, compared to placebo. In the competitive sports world, a 2-3% improvement is the difference between first place and tenth place.

Study 3: Mario Siervo, meta-analysis on blood pressure, 2013

A meta-analysis published in The Journal of Nutrition compiled 16 controlled studies with 254 participants. The finding: consumption of inorganic nitrate and beetroot juice reduced systolic blood pressure by an average of 4.4 mmHg (95% confidence interval: 2.8 to 5.9). For comparison, such a reduction in blood pressure is similar to the benefit of some medications and is linked to a significant reduction in the risk of stroke and heart disease.

What About Long-Term Heart Health?

Beyond workouts, beetroot extract interests aging researchers for another reason: the ability to produce nitric oxide declines with age. The vascular lining (endothelium) becomes less efficient at producing the molecule, and this is one of the causes of arterial stiffness, high blood pressure, and reduced blood flow to the brain.

Dietary nitrate from beetroot bypasses the aging endothelium and provides an alternative source of nitric oxide through the nitrate-nitrite pathway. Preliminary studies are examining whether this can improve cognitive function in the elderly by increasing blood flow to brain regions. The evidence is still early, but the direction is promising: what is good for the athlete's blood vessels is also good for the older adult's blood vessels.

Should Everyone Take Beetroot Extract?

Despite the strong evidence, there are several important caveats:

• The response is highly individual. Some people respond strongly, others hardly at all. Studies indicate large variability between individuals in the effect on blood pressure.
• Trained athletes benefit less. Elite athletes already have very efficient endothelium, so the improvement for them is smaller than for recreational exercisers.
• Mouthwash destroys the effect. Antibacterial mouthwash kills the bacteria on the tongue that convert nitrate to nitrite. Anyone using mouthwash before exercise negates the benefit.
• Urine and stool color changes. A completely benign phenomenon (Beeturia), reddish urine, not dangerous but may be alarming.
• Caution with blood pressure medications. If you are already taking blood pressure-lowering medications, combining with beetroot may lower it excessively. Consult a doctor.

The bottom line: Beetroot extract is a green evidence-grade supplement, safe, relatively inexpensive, and research-based. It is not magic, but it is one of the few that truly does what it promises. Purchase beetroot extract on iHerb.

What to Take Away from the Research?

1. Time it right. Consume the extract about 2-3 hours before exercise, so that blood nitric oxide levels peak just as you start training.
2. Look for nitrate dose, not volume. The effective dose is 6 to 13 millimoles of nitrate. Check the label; not all beetroot extracts provide enough nitrate.
3. Do not use mouthwash before exercise. You kill the bacteria that convert nitrate to nitrite, negating all the benefit.
4. If you manage blood pressure, talk to a doctor. The benefit is real, but in combination with medications, supervision is needed.
5. Remember it is a supplement, not a replacement. Beetroot extract improves performance by 2-3%. Consistent training, sleep, and nutrition provide the remaining 95%.

Want to know which supplements are exactly right for your training and health goals? Try our personal supplement selector, which provides evidence-ranked recommendations based on age, gender, and goals.

The Broader Perspective

Beetroot extract is a perfect example of a principle that recurs again and again in the longevity world: sometimes the most effective interventions are also the simplest. Instead of an exotic molecule costing hundreds of shekels, it is a concentrate of a vegetable that grows in every garden, activating an ancient biological pathway that evolution has fine-tuned with great precision.

The real beauty is that the same mechanism that improves the cyclist's time trial also protects the older adult's heart. Vascular health is the common denominator between physical performance and longevity, and nitric oxide stands at the heart of both. Sometimes, the path to living longer and training better goes right through that same purple root vegetable already in your fridge.

References:
Bailey SJ et al., Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans, Journal of Applied Physiology, 2009
Siervo M et al., Inorganic Nitrate and Beetroot Juice Supplementation Reduces Blood Pressure in Adults: A Systematic Review and Meta-Analysis, The Journal of Nutrition, 2013