Harnessing Nutrition for Healthy Aging: Beetroot Juice and Beyond

Beetroot-derived nitrates reliably improve endurance and muscular power in recreational and older adults, offering a practical, food-based ergogenic strategy that leverages nitric oxide physiology. Systematic-review–level evidence across randomized trials and pooled analyses shows clinically meaningful effect sizes for endurance and power that are relevant to functional capacity and rehabilitation planning.

Randomized trials and meta-analyses in recreational and moderately trained adults—including older participants in several studies—examined endurance (time-to-exhaustion, oxygen cost) and muscular power after ingestion of beetroot-derived nitrates. Pooled results show typical endurance gains of roughly 2–7% and peak or mean power increases commonly around 4–6%, although effects are larger and more consistent in less-trained cohorts and smaller or absent in highly trained athletes. These physiological changes frequently translate into measurable functional benefits for aging populations, such as longer walking distances and higher exercise tolerance.

Evidence for cognitive benefits is limited and inconsistent: some short-term trials report modest improvements in processing speed or executive tasks and changes in cerebral blood flow surrogates, but findings are not reproducible or clinically actionable. Most cognitive studies were short (acute to a few weeks) and enrolled younger or middle-aged adults rather than frail older patients. Larger, targeted trials in older adults are required before recommending beetroot-derived strategies for cognition in clinical practice.

Beetroot juice is generally well tolerated within trial-tested nitrate ranges and has a reassuring short-term safety profile. Common, benign effects include beeturia and mild gastrointestinal upset; most protocols used practical dosing (about 6–12 mmol nitrate) administered ~2–3 hours before exercise with standardized beetroot juice preparations. Clinicians should be aware of potential hypotension when combined with antihypertensives, product-to-product variation in nitrate content, and the lack of long-term safety and adherence data in older adults, which underscores the need for longer-duration studies to define tolerability in geriatric populations.