R E V I E W Open Access
Effects of beetroot juice supplementation
on intermittent high-intensity exercise
, José Luis Maté-Muñoz
, Eduardo Cuenca
, Pablo García-Fernández
, Fernando Mata-Ordoñez
María Carmen Lozano-Estevan
, Pablo Veiga-Herreros
, Sandro Fernandes da Silva
Manuel Vicente Garnacho-Castaño
Abstract: Beetroot juice contains high levels of inorganic nitrate (NO
) and its intake has proved effective at increasing
blood nitric oxide (NO) concentrations. Given the effects of NO in promoting vasodilation and blood flow with beneficial
impacts on muscle contraction, several studies have detected an ergogenic effect of beetroot juice supplementation on
exercise efforts with high oxidative energy metabolism demands. However, only a scarce yet growing number of
investigations have sought to assess the effects of this supplement on performance at high-intensity exercise. Here we
review the few studies that have addressed this issue. The databases Dialnet, Elsevier,Medline,PubmedandWebof
Science were searched for articles in English, Portuguese and Spanish published from 2010 to March 31 to 2017 using
the keywords: beet or beetroot or nitrate or nitrite and supplement or supplementation or nutrition or “sport nutrition”
and exercise or sport or “physical activity”or effort or athlete. Nine articles fulfilling the inclusion criteria were identified.
high-intensity efforts with short rest periods. The improvements observed were attributed to faster phosphocreatine
resynthesis which could delay its depletion during repetitive exercise efforts. In addition, beetroot juice supplementation
could improve muscle power output via a mechanism involving a faster muscle shortening velocity. The findings of
some studies also suggested improved indicators of muscular fatigue, though the mechanism involved in this effect
Keywords: Beet, Ergogenic aids, Exercise, Sport supplement
Because of the increase in competitive equality in high level
sport, a 0.6% performance improvement is today consid-
ered sufficient to make a difference . In this setting of
high competition, athletes often look to nutritional supple-
ments to boost their performance . However, most state-
ments about the potential effects on sport performance or
health that appear on the labels of many products are not
backed by clear scientific evidence . Because of this,
institutions such as the Australian Institute of Sport (AIS)
have created a system to classify supplements according to
their effects on performance based on confirmed scientific
evidence . Thus, dietary supplements assigned to class A
have been proven with a high level of evidence to improve
exercise performance in certain modalities when taken in
appropriate amounts. The only substances in this class are
β-alanine, sodium bicarbonate, caffeine, creatine and beet-
root juice . However, it is thought that the effect of a
given supplement on performance besides the recom-
mended dose may be specific to each sport’smodality.
This, in turn, will depend on the energy and/or mechanical
requirements of each form of exercise such that some
supplements will have an ergogenic effect on some types of
exercise efforts and have no effects on other types.
The relationship between exercise intensity and time to
exhaustion is hyperbolic  as it is directly linked to the
prevailing energy producing systems during exercise .
Thus, depending on their bioenergetics, the different exer-
cise efforts can be classified according to exercise duration.
This means we can differentiate between explosive efforts,
* Correspondence: firstname.lastname@example.org
Physical Activity and Sport Sciences, College of Health Sciences, Alfonso X El
Sabio University, Madrid, Spain
Full list of author information is available at the end of the article
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Domínguez et al. Journal of the International Society of Sports Nutrition
high-intensity efforts and endurance-intensive efforts .
Explosive efforts are those lasting under 6 s in which the
main energy metabolism pathway is the high-energy
phosphagen system and there is some participation also of
glycolysis [9, 10], which gradually contributes more energy
until 50% at 6 s . High-intensity efforts are those of dur-
efforts are characterized by a major contribution of
glycolytic metabolism and smaller contribution of high-
energy phosphagens and oxidative phosphorylation . Fi-
nally, intensive endurance efforts are those lasting longer
than 60 s and whose main energy producing system is
oxidative phosphorylation .
Beetroot juice is used as a supplement because it may
serve as a precursor of nitric oxide (NO) . The mech-
anism of NO synthesis is thought to be via the catabolism
of arginine by the enzyme NO synthase . Effectively,
arginine supplementation has been shown to increase NO
levels . An alternative mechanism of NO genesis is
mediated by inorganic nitrate (NO
). This means that the
high amounts of NO
present in beetroot juice are able to
increase NO levels in the organism.
In the mouth, some 25% of dietary NO
is reduced by
reductase produced by microorganisms  to ni-
) . This NO
is then partially reduced to
NO through the actions of stomach acids which is later
absorbed in the gut . Some of this NO
bloodstream, and, in conditions of low oxygen levels,
will be converted into NO  (Fig. 1).
Nitrous oxide has numerous physiological functions in-
cluding haemodynamic and metabolic actions [19, 20].
Mediated by guanylyl cyclase , NO has an effect on
smooth muscle fibres causing blood vessel dilation .
This vasodilation effect increases blood flow to muscle fi-
bres  promoting gas exchange . NO also induces
gene expression , enhancing biogenesis  and mito-
chondrial efficiency . All these effects can favour an
oxidative energy metabolism. In effect, though not all [28–
31], numerous investigations have noted that beetroot juice
supplementation boosts performance in exercise modalities
involving intensive endurance efforts in which the domin-
ant type of energy metabolism is oxidative [24, 27, 32–45].
To date, several reviews of the literature have assessed
the effects of beetroot juice supplements on physical exer-
cise [12, 46–49]. In addition, given that NO can potentiate
the factors that limit performance when executing actions
in which the predominant metabolism is oxidative, two re-
cent reviews have explored the positive effects of this form
of supplementation on endurance exercise [50, 51]. Thus,
the different studies showed that beetroot juice supple-
mentation was effective at: lowering VO
by −6% during a
swimming test conducted at an intensity equivalent to the
Fig. 1 Conversion of NO
in beetroot juice to NO. The diagram shows how ingested NO
is transformed by bacteria in the mouth containing
nitrite reductase to NO
. Once in the gut, NO
enters the bloodstream and, under conditions of hypoxia, is used to generate NO
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 2 of 12
ventilatory threshold (VT) ; lowering VO
during a kayaking test conducted at 60% VO
during a cycle ergometry test conducted by recreation
sport athletes  and cyclists  at 45–70% VO
creasing performance by 12–17% in cycle ergometry tests
until exhaustion conducted at intensities of 60 to 90%
by recreation sport athletes [37, 42], and by 22%
when conducted at a 70% intensity between VT and
; and finally, improving times by 2.8% in
trained cyclists conducting cycle ergometery tests of 4 km
, 10 km (1.2%) , 16 km (2.7%)  and 50 miles
(0.8%) . However, besides the effects of NO mentioned
above, other impacts need to be considered. Accordingly,
it has been described that the effect of increased blood
flow induced by NO is specific to type II muscle fibres
. Moreover, in type II muscle fibres, beetroot juice in-
take has been found to improve the release and later re-
uptake of calcium from the sarcoplasmic reticulum .
This could translate to an increased capacity for muscle
strength production of these type II muscle fibres. Such
effects of NO could mean a physiological advantage for ef-
forts involving the recruitment of type II muscle fibres,
such as intermittent, high-intensity efforts. Hence, given
the scarce yet growing number of studies that have ad-
dressed the effects of beetroot juice supplementation on
this type of intermittent, high-intensity effort [38, 53–60],
here we review the results of experimental studies that
have specifically examined in adults (whether athletes or
not) the effects of beetroot juice supplementation on
intermittent, high-intensity efforts.
We identified all studies that have assessed the effects of
BJ supplementation on intermittent, high-intensity efforts
by searching the databases Dialnet, Elsevier, Medline,
Pubmed and Web of Science published up until March
31, 2017 using the keywords: beet OR beetroot OR nitrate
OR nitrite (concept 1) AND supplement OR supplementa-
tion OR nutrition OR “sport nutrition”(concept 2) AND
exercise OR sport OR “physical activity”OR effort OR
athlete (concept 3).
Two of the present authors (E.C and P.G-F) first elimi-
nated duplicate articles and then removed descriptions of
studies that were not experimental, were not written in
English or Spanish, or were published before 2010. This
meant that all the studies reviewed were published over
the period January 1, 2010 to March 31, 2017. Next, these
two same authors applied a set of exclusion criteria to
ensure the selection only of studies specifically designed to
assess the effects of BJ supplementation on intermittent,
Studies performed in non-adults (samples including
subjects aged <18 or >65 years).
Studies conducted in vitro or in animals.
Studies in which the direct effects of BJ were not
Studies in which impacts were examined on
exercises that did not comply with the
characteristics of intermittent, high-intensity efforts.
If there was disagreement about whether a given study
met the inclusion/exclusion criteria, the opinion of a
third researcher (F.M-O) was sought.
Of 738 studies identified in the search, 359 were left
after eliminating repeated records. Once, the titles and
abstract of these 359 publications were reviewed, 212 full
text articles were indentified and retrieved for assess-
ment, of which 9 articles met the elegibility criteria
The nine studies selected for our review included a total
of 120 subjects, 107 of whom were men and 13 women.
In five of these studies [38, 53, 54, 57, 59], the effects of a
single beetroot juice supplement (acute effects) were
assessed. The supplement was taken 120 min before exercise
and 180 min before exercise in the remaining two [38, 54].
In the remaining four studies, the effects of chronic beet-
root juice supplementation were examined [55, 56, 58, 60].
The supplementation periods were 5 days in one study ,
6 days in two [55, 58] and 7 days in the fourth study .
Doses of NO
ingested ranged from ~5 mmol  to
~11.4 mmol . In addition, one study examined the
efficacy of beetroot juice taken separately or in combin-
ation with sodium phosphate .
In four of the nine studies reviewed, participants were
competition athletes [38, 55, 57, 59] and in the other five
they were recreation sport or low-level competition ath-
letes [53, 54, 56, 58, 60]. Only one of the study popula-
tions included athletes of individual sports modalities
, the rest of the studies were conducted in players of
team sports [53–60].
The tests used to assess performance were a 30-s dur-
ation cycle ergometer test in one  and high-intensity,
intermittent exercises in the remaining studies with
work intervals ranging from 6 s  to 60 s  and rest
periods from 14 s  to 4 min . The types of tests
employed were running at maximum speed in three
studies [55–57], cycle ergometry in four [53, 54, 59, 60],
one of which was an isokinetic test , a kayak ergom-
eter test in one  and bench press strength training in
the remaining study .
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 3 of 12
The beetroot juice intervention led to significantly im-
proved performance in four of the studies [54, 56, 58,
60], while in another four no such effects were observed
[38, 55, 57, 59]. In the remaining study, an ergolytic, or
reduced performance, effect was noted in relation to the
reviewed and provide details on the participants, experi-
mental conditions, supplement regimens, and performance
Effects of chronic supplementation with beetroot juice on
intermittent, high-intensity exercise efforts
Four of the studies reviewed tested the effects of taking
beetroot juice supplements for 5 to 7 days on intermittent,
high-intensity efforts [55, 56, 60] or on a resistance training
session . Three of these studies detected a significant
effect of beetroot juice supplementation [56, 58, 60] while
in the remaining study, no significant difference compared
with the placebo was noted .
Effects of chronic supplementation with beetroot juice on
Resistance training is used to improve muscular hyper-
trophy, strength, power and muscular endurance .
Training sessions targeting muscle hypertrophy include
workloads of around 70–85% 1 RM and 8–12 repetitions,
while those aiming to improve muscular endurance include
loads of around 50% 1 RM and some 15–25 repetitions
. Such exercise sessions are largely dependent on glyco-
lytic metabolism; the lactate threshold in resistance training
exercises such as half squat is detected at ~25% 1 RM [63,
64]. To determine the effects of 6 days of beetroot juice
supplementation (6.4 mmol NO
) on resistance training
sessions designed to improve local muscular hypertrophy
and endurance, in the study by Mosher et al. reviewed here
, the number of bench press repetitions accomplished
in three sets using loads equivalent to 60% 1 RM was re-
corded. Results indicated that supplementation increased
the number of repetitions in the three exercise sets improv-
ing session performance by 18.9%.
In an earlier investigation, the effects of sodium bicar-
bonate supplements were assessed in a similar study to the
exhaustion with loads of 10–12 RM in three exercises
Fig. 2 Article selection
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 4 of 12
targeting the lower limbs . Results indicated that, like
the beetroot juice, sodium bicarbonate supplementation
led to more repetitions in the session . However, in par-
allel with the increasing number of repetitions, blood lac-
tate concentrations also rose (~2.5 mmol) . This was
not observed in Mosher’s study .
If we consider the nature of resistance training, the ath-
lete passes from a resting condition to a situation demand-
ing high energy levels during the first repetitions of a set.
Because the phosphagen system is the main energy path-
way in rest-exercise transitions , phosphocreatine re-
serves may be depleted in response to a resistance training
Table 1 Summary of the results obtained in studies examining the impacts of beetroot juice supplements on intermittent high
intensity exercise performance
Reference Subjects Study design Dose Exercise test Results
Muggeridge et al.  Trained kayakers
± 6.1 ml·kg·min
5 mmol NO
(180 min before)
5 × 10 s sprint-rest
+4% average power
(420 ± 23 vs 404 ± 24 W)
et al. 
sport players (male,
n= 16) (VO
47.2 ± 8.5 ml·kg·min
6.4 mmol NO
(120 min before)
sets until exhaustion
of 8 s–rest 30 s
−13% reps (13 ± 5 vs 15 ± 6)
and −17% total work (49.2 ±
24.2 vs 57.8 ±34.0 kJ)
Aucouturier et al.  Recreation team sport
players (male, n= 12)
46.6 ± 3.4
10.9 mmol NO
(180 min before)
sets until exhaustion
of 15 s at 170%
MAP–rest 30 s
(26.1 ± 10.7 vs
21.8 ± 8.0) and 18% total
(168.2 ± 60.2 vs
142.0 ± 46.8 kJ)
et al. 
Amateur team sport
players (female, n= 13)
BJ: 6.4 mmol NO
(6 days) BJ + SP:
6.4 mmol NO
50 mg·kg lean
mass SP (6 days)
PRE, MID and POST
sport matches: 6×(20
m sprint + rest 25 s)
BJ: −0.2% total sprint time
per set (69.8 ± 4.9 vs 69.97
± 4.2) BJ + SP: −2% total
sprint time per set (68.9 ±
5.1 vs 69.97 ± 4.2)
Thompson et al.  Recreation team sport
players (male, n= 16)
50 ± 7
MID and POST simulated
2×[5×(6 s cycle ergometry
sprint + rest 14 s)]
5% work volume at MID
(63 ± 20 vs 60 ± 18 kJ),
2% POST (60 ± 17 vs 59
± 16 kJ) and 4% whole
(123 ± 19 vs
119 ± 17 kJ)
et al. 
sport players (male,
n= 20) (VO
11.4 mmol NO
(150 min before)
2xRST: 20×(30 m
sprint–rest 30 s)
-1% average sprint time
RST1 (4.65 ± 0.3 vs 4.7 ±
0.2 s) and −2% RST2
(4.66 ± 0.2 vs 4.77 ± 0.2 s)
and −2% fastest sprint RST1
(4.41 ± 0.2 vs 4.48 ± 0.1 s)
and −3%RST2 (4.38 ± 0.2
vs 4.53 ± 0.2 s)
et al. 
n= 12) (VO
Bench press: 3×
reps at 60% 1 RM)
+ 19% weight lifted in
session and improved
no. of reps S1
and whole session.
et al. 
players (male, n= 13)
11.2 mmol NO
(150 min before)
-1% peak power (1173
± 255 vs 1185 ± 249 W)
and −1% total work
(22.8 ± 4.8 vs 23 ± 4.8 W)
Wylie et al.  Recreation team sport
players (male, n= 10)
58 ± 8
Cycle ergometer: 24 x
(6 s sprint–rest 24 s)
Cycle ergometer: 7 x
(30 s sprint–rest 4 min)
Cycle ergometer: 6 x
(60 s sprint–rest 60 s)
+5% mean average power
(568 ± 136 vs 539 ± 136 W)
and +1% mean peak power
(792 ± 159 vs 782 ± 154 W)
in 24 x (6 s sprint–rest 24 s);
−1% mean average power
(558 ± 95 vs 562 ± 94 W) and
−1% mean peak power (768
± 157 vs 776 ± 142 W) in 7 x
(30 s sprint–rest 4 min)
BJ Beetroot juice, MID Half-time simulation match, nSample size; no Number, NO
nitrate concentration in the drink, MAP Maximum aerobic power, POST End
simulation match, PRE Before simulation match, Rep Repetition, RST Repeated sprint test, SP Sodium phosphate, VO
Peak oxygen consumption,
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 5 of 12
exercise set. Recovering these reserves takes some 3–
5 min . Given that phosphocreatine resynthesis is
dependent on oxidative metabolism  and that beetroot
juice has an ergogenic effect on exercise modalities with a
major oxidative metabolism component , it could be
that this supplement accelerated this recovery during the
rest period in Mosher’s study (2 min) and thus avoided
progressive phosphocreatine depletion throughout the ses-
sion. In turn, this faster rate of resynthesis would attenuate
the increasing levels of adenosine diphosphate (ADP) and
inorganic phosphates . Both these metabolites have
been associated with the appearance of muscular fatigue
. Hence, by delaying the build-up of critical levels of
these metabolites, the appearance of fatigue will be delayed
and this will allow for more repetitions in sets until ex-
haustion . NO
supplementation could also improve
muscle efficiency and contractile capacity by promoting
the release of calcium from the sarcoplasmic reticulum in
the muscle cells and its reuptake [52, 69]. Thus, a train of
action potentials leading to an increased supply of calcium
to the muscle fibre will increase the strength of muscle
Effects of chronic supplementation with beetroot juice on
intermittent high-intensity exercise efforts
Some sport modalities such as team, racket or combat
sports require bursts of high-intensity efforts followed
by rest periods. Thus, in team sports, high-intensity ef-
forts (~3–4 s) are interspersed with variable active rest
periods . In racket sports like tennis, efforts last 7–
10 s and rest periods 10–16 s (between points) and/or
60–90 s (side changes) . Finally, in combat sports
more intense efforts are 15–30 s long and active rest pe-
riods are 5–10 s long every 5 min . In all these
sports modalities, the capacity to repeat high-intensity
efforts with only short recovery periods is considered a
performance indicator . This means that higher level
athletes are able to maintain performance in successive
high-intensity intervals over a long time period .
To find out if beetroot juice supplementation would im-
prove this ability to repeat high-intensity efforts during a
team sport match, Thompson et al.  administered
beetroot juice over 7 days to a group of athletes
(12.8 mmol NO
). The performance test consisted of two
blocks of five 6-s sets of sprints on a cycle ergometer with
14-s active recovery periods in the middle and end of a
simulated match lasting 2 × 40 min . The results of
this study indicated a total work volume improved by
3.5% in the whole session, though this improvement was
greater at the end of the first half (at half time).
If we again consider the nature of this type of exercise, it
has been established that it involves the recruitment of
type II muscle fibres [75, 76], which are more powerful
though show more fatigue than type I units . This
lesser resistance to fatigue has been related to reduced
blood flow and myoglobin concentrations in these muscle
fibres compared to type I. Hence, type II muscle fibres are
designed to promote non oxidative pathways and have
shown a greater creatine storage capacity  for an en-
hanced metabolism of phosphocreatine  and proteins
with a buffering effect at the intracellular level such as
carnosine , favouring a glycolytic type metabolism.
Animal studies have shown that increased blood flow in
response to NO
supplementation is greater in type II com-
pared to type I muscle fibres . This greater irrigation
and oxygen availability in the recovery period along with a
greater creatine storage capacity of motor type II units 
(promoting phosphocreatine resynthesis ) means that
during an exercise effort followed by a short rest period
(14 s), beetroot juice supplementation could delay
phosphocreatine depletion during successive sprints and
explain the improvements noted by Thompson et al. .
Despite such greater effects of NO
on type II versus type I muscle fibres, animal studies
have also shown that effects on calcium release and re-
uptake in the muscle cell sarcoplasmic reticulum is
greater in type II than type I muscle fibres . Accord-
ingly, because of the important role of type II muscle fi-
bres during sprints [75, 76], supplementation could have
led to an improved capacity to generate muscle power
and thus explain the significant improvements in per-
formance observed by Thompson’s group.
Buck et al.  examined the effects of 6 days of sup-
plementation with beetroot juice (6.4 mmol NO
) or so-
dium phosphate (50 mg·kg lean mass) on performance
in a test consisting of repeated sprints as 6 sets of 20 m
and 25-s of rest between sets in the middle and end of a
simulated match lasting 60 min. The beetroot juice
intervention did not improve performance at these
sprints, yet did do so when taken along with sodium
phosphate (2%) compared with placebo, though this im-
provement was of lesser magnitude than when the sub-
jects only took sodium phosphate supplements (5%).
These findings suggest that, unlike beetroot juice, so-
dium phosphate intake may have an ergogenic effect in
this protocol. If we compare the tests used by Buck et al.
 and Thompson et al. , work periods were
shorter (2–3 vs 6 s), while rest periods were longer (25
vs 14 s). Therefore it could be that 2–3 s efforts lead to
a significantly lower reduction of phosphocreatine re-
serves at the end of these efforts. Further, the 25 s of rest
approaching the 30 s in which the recovery of 50% of
phosphocreatine stores takes place , may have been
sufficient to stabilize reserves of phosphocreatine and
therefore avoid the appearance of fatigue .
Another study investigated the effects of longer term
supplementation (5 days) with beetroot juice (8.4 mmol
), this time on performance in a repeated high-
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 6 of 12
intensity test . These authors sought to determine
supplementation effects on different exercise protocols.
Subjects performed a session consisting of twenty four
6-s sets of work and 24 s of rest between sets, a second
session of two 30-s sets of work and 2 min of rest be-
tween sets and a third session of six 6-s sets and 60 s of
rest between sets. As did Thompson et al. , Wylie et
al.  selected 6-s exercise sets in the first session
though rest intervals were longer (24 vs 14 s). Another
difference was that the participants had not first under-
gone fatigue (in the simulated team sport match) before
the performance test. Notwithstanding, results were
similar in that mean power generated in the sets over a
whole session improved by ~7%. However, improve-
ments across the 24 × 6–24 protocol were not compar-
able to those recorded in the other two tests, in which
no significant improvements were recorded.
In the test protocols including 30-s and 60-s work ef-
forts, beetroot juice supplementation resulted in no im-
provements in any indicators of performance . These
protocols consisting of longer duration work intervals
mainly involve a glycolytic type metabolism and in smaller
measure elicit the high-energy phosphagen system. An in-
crease in glycolysis leads to increased H
ering pH . To avoid increasing acidosis, a series of
responses targeted at reducing phosphofructokinase take
place including diminished glycolysis  and phospho-
creatine resynthesis , and muscle contractibility modi-
fications . Such responses manifest as reduced non
aerobic metabolism or a reduced capacity for muscle
power and strength, in other words, fatigue . Supple-
ments such as β-alanine (which increases muscle carno-
sine concentrations , a protein that acts as a buffer
inside the cell ) and sodium bicarbonate  (main
extracellular buffering agent) have shown ergogenic effects
on performance at high-intensity efforts involving the pre-
dominance of glycolytic metabolism . The combined
effect of these supplements is greater than the impact of
each supplement on its own .
Although beetroot juice supplementation induces vaso-
dilation and increased blood flow (in type II muscle fibres,
recruited mainly in exercise bouts of 30 to 60 s duration),
increasing available oxygen in the muscles, rather than be-
ing activated because of a lack of oxygen (anaerobiosis),
non-oxygen dependent pathways are activated because of a
greater demand for energy production via oxidative phos-
phorylation. Thus, these effects, although they potentiate
oxidative phosphorylation, have no repercussions on glyco-
lytic energy metabolism. Hence, as beetroot juice has no al-
kalizing effect supplementation with this product is unable
to reduce acidosis, as the main factor limiting performance
at efforts lasting 30–60 s. However, potentiating effects on
aerobic metabolism increases the speed of phosphocreatine
resynthesis, dependent on oxidative phosphorylation. This
means it may be effective for repeated high-intensity efforts
whose duration is close to 6–10 s, in which high energy
phosphagens contribute mainly to the metabolism  and
the work volume is sufficient to cause significant depletion,
which when faced with short rest intervals leads to pro-
gressive depletion and consequently to fatigue. Accord-
ingly, beetroot juice supplements can have an ergogenic
effect when exercise efforts are intermittent, maximum in-
tensity, short-duration (6–10 s) and interspersed with brief
recovery periods (<30 s).
Effects of acute beetroot juice supplementation on
intermittent high-intensity efforts
Five of the studies reviewed here were designed to analyze
the effects of a single beetroot juice supplement on inter-
mittent high-intensity exercise efforts [38, 53, 54, 57, 59].
Aucouturier et al.  administered the supplement
(~10.9 mmol NO
) to a group of recreation athletes
180 min before performing sets until exhaustion consist-
ing of 15 s of pedalling at 170% VO
followed by 30-s
rest periods. The authors reported that the beetroot sup-
plement gave rise to improvements close to 20% in the
number of repetitions performed and the total work com-
pleted in the session . Besides the number of sets com-
pleted and the work accomplished, these authors
measured red blood cell concentrations at the micro-
vascular level. The beetroot juice, apart from improving
performance, was found to increase microvascularization.
Such improvements are considered a beneficial effect on
oxygen exchange in the muscle . Accordingly, these
oxygen availability improvements produced at the muscu-
lar level could have potentiated oxidative phosphorylation
during rest periods, and, given their brief duration, could
have increased phosphocreatine resynthesis when subjects
took the supplement rather than the placebo. Thus, sup-
plementation would have delayed the depletion of
phosphocreatine reserves and this effect was likely the
cause of the improvements observed in the repeated sets
of intermittent sprints [94, 95].
As did Aucouturier et al. , Muggeridge et al.  ex-
amined the effect of beetroot juice (5 mmol NO
180 min before an intermittent effort consisting of 5 sets
of 10 s in a kayak ergometer with 50-s interset rest periods.
In this study, though supplementation seemed to have a
greater effect on the power generated in the last two sets,
the improvement noted lacked significance. However, if we
compare this study with the study by Aucouturier et al.
, work periods in the Muggeridge study  were
shorter (10 vs 15 s) and rest periods were much longer (50
vs 30 s). Ten second maximum intensity intervals have a
significantly reduced capacity compared with 15s intervals
to deplete phosphocreatine reserves. Moreover, the rate of
phosphocreatine replacement has a first phase in which up
to 50% of these reserves can be replenished in 30 s and
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 7 of 12
100% in 3–5 min . Also if we consider that the main
effect of beetroot juice supplements is linked to an im-
proved rate of phosphocreatine resynthesis, it is possible
that as there is less depletion and a rest period in which
there is almost complete recovery of phosphocreatine re-
serves, supplementation could not have exerted any bene-
ficial effect in the study by Muggeridge et al. .
However, despite the short work periods and relatively
long recovery periods and the fact that the power devel-
oped in the last sets showed an improved trend following
supplementation, it is possible that lengthening intervals
in a set until exhaustion would have been beneficial and
given rise to similar results to those observed by Aucou-
turier et al. .
Rimer et al.  assessed the effects of acute supplemen-
tation (150 min before exercise) with beetroot juice
(11.2 mmol NO
) on performance in a maximal intensity
3-s test on an isoinertial cycle ergometer and a 30-s test on
an isokinetic cycle ergometer. Supplementation was effect-
ive at improving pedalling cadence, and thus the power
generated, in the 3-s test. However, no such effect was ob-
served in the isokinetic test.
The improvements noted by Rimer’s group in the 3-s
test affected pedalling cadence. Because of the link be-
tween such improvements and an increase in muscle
shortening velocity  and the proposal that NO could
increase this velocity [97, 98], the authors suggested that
beetroot juice could have a beneficial effect on power
output . This rationale was also used to explain the
lack of changes produced in the 30-s test in which ped-
alling cadence was fixed at 120 rpm. This means that
any improved power production in the isokinetic test
could only occur if there was an increase in power at a
constant shortening velocity , since power equals
force times velocity.
In a later investigation performed in CrossFit athletes, it
was reported that supplementation with NO
salts (8 mmol
) rather than beetroot juice was able to improve per-
formance in a 30-s cycle ergometry test . However, un-
like the 30-s test used by Rimer et al. , the test was
isoinertial. The difference between the 2 cycle ergometers
is that while in the isokinetic test pedalling cadence is pre-
fixed and improvements only in strength are possible, in
an isoinertial test the workload is fixed and any power im-
provements produced manifest as improvements in pedal-
ling cadence. Given that beetroot juice supplementation
could improve power development as a consequence of a
reduced muscle shortening velocity [59, 97, 98], the isokin-
etic cycle ergometer is perhaps not sufficiently sensitive to
assess the effects of this supplementation. Considering the
beneficial effects on cadence and power output observed
in the cycle ergometry 3-s  and 30-s  tests, it seems
that beetroot juice supplementation could have a beneficial
effect on this type of effort.
In a fourth study, Clifford et al.  assessed the ef-
fects of a single intake of beetroot juice on performance
in a test of 20 sets of 30 m sprints interspersed with 30-s
rest periods. These authors observed no ergogenic ef-
fects of the supplementation. However, if we look at the
characteristics of the test employed by the researchers,
we find that the work periods (close to 3 s) together with
the 30 s recovery periods could be sufficient for the sub-
jects to have recovered their phosphocreatine levels in
the rest intervals, minimizing the possible ergogenic ef-
fects of the supplementation.
A novel indicator used in this study by Clifford et al.
 was the counter-movement jump (CMJ) test per-
formed before the intermittent velocity test and in the
rest periods. Performance in this test is determined by
the contractile properties of muscle and by neuromuscu-
lar control of the entire musculoskeletal system .
Given that fatigue reflects the incapacity of the neuro-
muscular system to maintain the level of power required
, losses in CMJ height at the end of exercise are
taken as an indicator of muscular fatigue .
In the study by Clifford’s group , it was observed
that the protocol of intermittent sprints gave rise to
muscular fatigue. This fatigue can be the outcome of de-
ficiencies in the muscle’s contractile mechanism [101,
103]. Alternatively, strong eccentric actions of the ham-
string muscles during sprints may produce muscle dam-
age  and therefore modify the structure of the
muscle fibre’s sarcomeres. Thus, any loss in CMJ height
could indicate muscle damage. While CMJ was moni-
tored after the protocol of 20 sets of 30 m with 30-s rest
periods, a greater recovery of CMJ height was observed
in the supplementation group. This suggests that beet-
root juice could help preserve muscle structure during
high-intensity efforts. Another explanation could be re-
lated to the vasodilation effect of beetroot juice  pos-
sibly helping muscle regeneration during early recovery.
In future work, biomarkers of muscle damage or inflam-
mation need to be examined.
In the fifth study, Martin et al. investigated the effects
of beetroot juice (6.4 mmol NO
) on repetitive sets
until exhaustion each consisting of 8 s of work followed
by 30 s of rest on a cycle ergometer . No effects
were detected on power output in the different sets.
Moreover, a lower number of sets was accomplished in
the session for the supplementation group versus
placebo group. In effect, this was the only study to
describe an ergolytic effect of beetroot juice. The
authors argued that because of the scarce contribution
of oxidative phosphorylation to energy metabolism dur-
ing high-intensity efforts and that the ergogenic poten-
tial of this supplement is related to potentiating
oxidative pathways, no beneficial effects are produced
on this type of physical action.
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 8 of 12
The results of the investigation by Martin et al. 
conflict with those of others who did observe benefi-
cial effects on performance in similar tests [54, 56,
58, 60]. Beetroot juice was taken 120 min before ex-
ercise. This regimen is not appropriate, as peak NO
levels are produced 2–3 h after ingestion and it is
recommended that supplementation should be taken
at least 150 min–180 min before the high-intensity
effort [32, 50]. Effectively, Aucouturier et al.  used
a test of similar characteristics but the beetroot sup-
plement was taken 180 min before the exercises, as
To date, few studies have examined the effects of
supplementation with beetroot juice on short-duration
high-intensity exercise efforts [38, 53–60] and obser-
vations so far will need confirmation in future
–Supplementation with beetroot juice has been
shown to diminish the muscular fatigue associated
with high-intensity exercise efforts, though it is not
known if this is achieved by reducing fatigue and
muscle damage and/or promoting muscle regener-
–When faced with exercise efforts that could
considerably deplete phosphocreatine reserves (sets
of resistance training or repetitive sprints of around
15 s interspersed with short rest periods) and given
that phosphocreatine resynthesis requires an
oxidative metabolism, beetroot juice could help the
recovery of phosphocreatine reserves and thus avoid
its depletion during repeated efforts. In parallel,
supplementation would limit the build-up of metab-
olites such as ADP and inorganic phosphates, which
are known to induce muscular fatigue.
–Beetroot juice has been shown to improve the release
and reuptake of calcium at the sarcoplasmic reticulum.
improvements in muscle shortening velocity. Non-
isokinetic ergometers (in which movement velocity is
not assessed) are sensitive to such improvements in
The main limitation of our review is the scarcity of stud-
ies that have examined the effects of beetroot juice sup-
plementation on intermittent, high- intensity exercise.
This limitation is also magnified by the varied design of
the few studies available including different supplemen-
tation doses and regimens.
Future lines of research
As it has been proposed that beetroot juice
supplementation improves phosphocreatine
resynthesis during the brief rest periods included in
protocols of intermittent high-intensity exercise, future
studies are needed to confirm via a muscle biopsy
phosphocreatine levels during repeated high-intensity
To examine the possible beneficial effect of
beetroot juice on muscle shortening velocity
reflected as improved pedalling cadence, future
studies need to assess the ergogenic effect of this
supplement in a single, constant-load test on an
inertial cycle ergometer.
To elucidate the mechanism whereby beetroot juice
diminishes muscular fatigue and improves recovery
from this fatigue, the effects of ingesting NO
biomarkers of inflammation and muscle damage
need to be addressed.
According to the results of the study in which an
ergolytic effect was produced in response to a single
dose of beetroot juice administered 120 min before
exercise, future investigations should determine the
most appropriate timing of supplementation to
optimize its ergogenic potential.
Finally, owing to the possible beneficial impacts of
beetroot juice, we will need to assess the
interactions of beetroot juice with other
supplements of proven ergogenic effects in this type
of exercise effort such as caffeine, creatine, β-alanine
and sodium bicarbonate.
There were no sources of funding for this research.
Availability of data and materials
Data sharing not applicable to this article as no datasets were generated or
analysed during the current study.
R.D. and M.V.G.-G. conceived and designed the review; E.C., P.G.-F. and F.M.-
O. selected the articles included; E.C., M.C.L.-E. and P.V.-H. analyzed the
articles included; P.G.-F., F.M.-O. and P.V.-H. translated the manuscript into
English; R.D., J.L.M.-M., E.C., S.F.S. and M.V.G.-C. prepared the figures and
tables and drafted the manuscript; R.D., J.L.M.-M., E.C., P.G.-F., F.M.-O., M.C.L.-E.,
P.V.-H., S.F.S. and M.V.G.-C. edited and revised manuscript; R.D., J.L.M.-M., E.C.,
P.G.-F., F.M.-O., M.C.L.-E., P.V.-H., S.F.S. and M.V.G.-C. Approved the final version
of the manuscript.
Ethics approval and consent to participate
Consent for publication
The authors declare that they have no competing interests.
Domínguez et al. Journal of the International Society of Sports Nutrition (2018) 15:2 Page 9 of 12
Springer Nature remains neutral with regard to jurisdictional claims in
published maps and institutional affiliations.
Physical Activity and Sport Sciences, College of Health Sciences, Alfonso X El
Sabio University, Madrid, Spain.
TecnoCampus. GRI-AFIRS, School of Health
Sciences, Pompeu Fabra University, Mataró, Barcelona, Spain.
C/Paco León, 1, 14010 Córdoba, Spain.
Physical Activity and Sport Sciences,
Physical Education Departament, University of Lavras, Lavras, Brazil.
Received: 6 June 2017 Accepted: 7 December 2017
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