Rocket's dietary nitrate and the nitrate-nitrite-NO pathway
What it found
Dietary nitrate, found in rocket and beetroot, is recognised as an important source of nitric oxide in the body.
Studies in people show it can lower blood pressure, affect platelets, improve mitochondrial efficiency and help exercise, with no sign of tolerance over weeks.
What they found
Studies in people
Blood pressure, in people
In a 4-week trial of 68 patients with treated or untreated hypertension, daily beetroot juice lowered blood pressure across clinic, 24-hour and home measurements. The effect was sustained, suggesting no tolerance builds up with daily use.
Platelets, in people
When volunteers swallowed their saliva after beetroot juice, platelet aggregation fell and plasma nitrite rose. When they spat out saliva for 3 hours, plasma nitrite did not rise and platelet aggregation did not change.
Exercise and oxygen use
In healthy volunteers, inorganic nitrate reduced the oxygen cost of submaximal exercise. Muscle biopsies showed a 23% improvement in the amount of oxygen consumed per ATP produced after nitrate was taken.
Exercise in patients
In patients with peripheral arterial disease, a single dose of beetroot juice increased time before claudication by 18% and total walking time by 17%. In patients with COPD, 3 of 5 studies found an effect of dietary nitrate on exercise.
Animal and lab studies
Platelets, in rats
In rats given nitrite by injection, platelet aggregability stayed the same or even increased. The authors suggested this might mean nitrite is not readily converted to NO in the circulation under normal oxygen levels.
Studies in people and animals
Cancer risk and vegetables
The World Cancer Research Fund reports strong evidence that non-starchy vegetables, including several high-nitrate green leafy ones, lower the risk of cancers of the mouth, pharynx, larynx, oesophagus and stomach. A review of animal and human studies found no link between nitrate or nitrite intake and stomach cancer risk when no carcinogenic nitrosamine precursor was given at the same time.
How it was done
The authors wanted to bring together recent developments that confirm the mechanisms of the nitrate-nitrite-NO pathway, extend understanding of it, and reveal new properties and potential therapeutic uses.
They reviewed studies in people, animals and cells covering blood pressure, platelets, endothelial function, ischaemia-reperfusion injury, mitochondrial efficiency, exercise, cancer risk and possible dietary combinations.
What it can’t tell you
- This is a review of many different studies, not one new experiment, so it cannot prove cause and effect for any single finding.
- Some of the results come from animals or cells, which cannot show what happens in people.
- The long-term effects of dietary nitrate are still not known.
Who paid
- Funding
- Funded by British Heart Foundation (from the PubMed record).
- Authors work at
- King's College London, SE NH; King's College London British Heart Foundation Centre, UK
The paper
- Title
- It is rocket science - why dietary nitrate is hard to 'beet'! Part II: further mechanisms and therapeutic potential of the nitrate-nitrite-NO pathway
- Type
- Study
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Mills CE, Khatri J, Maskell P, Odongerel C, Webb AJ (2017). It is rocket science - why dietary nitrate is hard to 'beet'! Part II: further mechanisms and therapeutic potential of the nitrate-nitrite-NO pathway. British journal of clinical pharmacology. doi:10.1111/bcp.12918Free full textPubMed 26914827DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error