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Systematic Review

  • A systematic review (Kurowska et al.)
  • Published: Central European Journal of Sport Sciences and Medicine Vol. 35, No. 3/2021
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Summary

The findings underscore the physiological importance of nitric oxide (NO) in enhancing exercise capacity, primarily through its vasodilatory properties that facilitate oxygen O2 and substrate delivery to working muscles, and its role in improving mitochondrial efficiency, leading to a reduced O2 cost of exercise.

Crucially, the review highlights the exogenous dietary pathway—specifically the intake of inorganic nitrates NO3 from sources like beetroot juice—as a viable alternative to the endogenous L-arginine pathway for NO generation. Despite some conflicting evidence within the existing literature, the collective data strongly suggest that beetroot juice consumption represents a low-cost, natural, and promising nutritional strategy. Its benefits appear most pronounced in enhancing sports performance across both endurance and high-intensity intermittent (start-stop) exercise modalities.

The authors position beetroot juice as a scientifically supported, natural performance enhancer with proven hemodynamic and metabolic benefits, though efficacy varies by athlete profile and sport demands.

Objective of the work

The aim of the study was to review the current literature on the properties of beetroot juice as an important source of nitrates (NO3–) and its effectiveness in improving the exercise capacity of physically active people.

Key Evidence-Based Benefits

Nitric Oxide (NO) Boost: Dietary nitrate (NO₃⁻) converts to nitrite (NO₂⁻) via oral bacteria, then to NO—improving vasodilation, oxygen delivery, and mitochondrial efficiency.

Performance Impact

  • Efficiency Boost: Reduced aerobic cost (VO₂) during submaximal exercise, enhancing energy metabolism and phosphocreatine resynthesis.
  • Endurance Benefits: Improved exercise tolerance, time-to-exhaustion, and performance in moderate-to-high-intensity activities (e.g., cycling, running).
  • Faster Recovery: Supports phosphocreatine resynthesis and reduces muscle fatigue.

Optimal Protocol

  • Timing: 2–3 hours pre-exercise for peak plasma nitrite.
  • Chronic Use: Chronic supplementation (up to 15 days) shows cumulative benefits, while single doses are effective for acute performance gains.

Critical Factors

  • Recommendations: Personalised dosing, timing adjustments, and combining with dietary strategies (e.g., low mouthwash use to preserve oral nitrate-reducing bacteria).
  • Variable Efficacy: Effects depend on individual factors (e.g., baseline nitrite levels, training status, oral microbiome health).

Read the full issues: https://wnus.usz.edu.pl/cejssm/en/issue/1210/article/19271/

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