---
title: "Impact of dietary nitrate supplementation on exercise capacity…"
description: "Dietary nitrate supplementation may lower blood pressure and improve exercise capacity during pulmonary rehabilitation, but its short-term impact on…"
url: "https://magellanlongevity.com/study/beet_meta2.md"
canonical: "https://magellanlongevity.com/study/beet_meta2.html"
html: "https://magellanlongevity.com/study/beet_meta2.html"
type: "study"
study_key: "beet_meta2"
journal: "BMJ Open Respiratory Research"
year: 2021
pmid: "34489239"
doi: "10.1136/bmjresp-2021-000948"
citations: 1
updated: 2026-09-02
author: "Gabriel Radu, DO"
author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765."
publisher: "Magellan Longevity"
content_format: "markdown"
---

# Impact of dietary nitrate supplementation on exercise capacity and cardiovascular parameters: a systematic review and meta-analysis

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## Citation

| Field | Value |
| --- | --- |
| Journal | BMJ Open Respiratory Research |
| Year | 2021 |
| PMID | [34489239](https://pubmed.ncbi.nlm.nih.gov/34489239/) |
| DOI | [10.1136/bmjresp-2021-000948](https://doi.org/10.1136/bmjresp-2021-000948) |
| Study key | beet_meta2 |

## Takeaway

Dietary nitrate supplementation may lower blood pressure and improve exercise capacity during pulmonary rehabilitation, but its short-term impact on exercise capacity is inconsistent.

## The question

Does dietary nitrate supplementation improve exercise capacity and cardiovascular parameters in individuals with respiratory disease?

## Hypothesis

Dietary nitrate supplementation, often from beetroot juice, may enhance exercise performance and endothelial function in people with respiratory disease.

## Methods

A systematic review and meta-analysis was conducted by searching PubMed, CINAHL, MEDLINE (Ovid), Cochrane, and Embase for clinical trials up to March 2021. Two independent authors screened and extracted data from studies evaluating dietary nitrate supplementation's efficacy on cardiovascular parameters and exercise capacity in chronic respiratory conditions. Eleven studies (two randomized controlled trials, nine crossover trials) with 282 participants were included after full-text review.

## Results

Pooled analysis showed dietary nitrate supplementation reduced systolic blood pressure by -3.39 mm Hg, diastolic blood pressure by -2.20 mm Hg, and mean arterial pressure by -4.40 mm Hg. It increased walk distance in the context of pulmonary rehabilitation (standardized mean difference 0.47), but no effect was found in short-term studies (standardized mean difference 0.08).

## Conclusion

Dietary nitrate supplementation may beneficially affect blood pressure and enhance exercise capacity when combined with pulmonary rehabilitation. However, short-term studies do not consistently show a benefit on exercise capacity.

## Limitations

The review included a relatively small number of studies (11) and participants (282). Only one large study (n=122) was conducted in the context of pulmonary rehabilitation, while others were single-dose or short-term.

## Verbatim from the abstract

> Dietary nitrate supplementation reduced systolic, diastolic and mean arterial pressure and augmented exercise capacity in the context of rehabilitation.

## Impact of Dietary Nitrate Supplementation on Blood Pressure

| Measure | Mean Difference (mm Hg) |
| --- | --- |
| Systolic BP Reduction | -3.39 |
| Diastolic BP Reduction | -2.2 |
| Mean Arterial Pressure Reduction | -4.4 |

*Dietary nitrate supplementation reduced systolic, diastolic, and mean arterial blood pressure.*

## Where this study is used on Magellan

This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions.

| Compound or device | Evidence grade | Graded pages |
| --- | --- | --- |
| Beetroot / Dietary Nitrate | Moderate evidence | [Beetroot / Dietary Nitrate](https://magellanlongevity.com/p/202.md) |

## Reference

1. **Impact of dietary nitrate supplementation on exercise capacity and cardiovascular parameters: a systematic review and meta-analysis**
   BMJ Open Respiratory Research 2021 · [PMID 34489239](https://pubmed.ncbi.nlm.nih.gov/34489239/) · [DOI 10.1136/bmjresp-2021-000948](https://doi.org/10.1136/bmjresp-2021-000948)

   > Dietary nitrate supplementation reduced systolic, diastolic and mean arterial pressure and augmented exercise capacity in the context of rehabilitation.

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## Related on Magellan Longevity

- [Beetroot / Dietary Nitrate](https://magellanlongevity.com/p/202.md) — product graded on this and related evidence
- [Beetroot Juice and Exercise Capacity: A Systematic Review and Meta-Analysis](https://magellanlongevity.com/study/beet_bp.md)
- [Therapeutic potential of beetroot juice in peripheral artery disease (review of the…](https://magellanlongevity.com/study/beet_no.md)
- [Longevity research map](https://magellanlongevity.com/longevity-research-map.html)
- [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md)

## Scope and disclosures

Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication.

Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases.

Reviewed for accuracy by a board-certified physician (DO).