Performance and Health Benefits of Dietary Nitrate Supplementation in Older Adults: A Systematic Review

Nutrients. 2017 Oct 27;9(11):1171. doi: 10.3390/nu9111171.


Supplementation with nitrate (NO₃-)-rich beetroot juice has been shown to improve exercise performance and cardiovascular (CV) responses, due to an increased nitric oxide (NO) availability. However, it is unclear whether these benefits are greater in older adults who have an age-related decrease in NO and higher risk of disease. This systematic review examines 12 randomised, crossover, control trials, investigating food-based NO₃- supplementation in older adults and its potential benefits on physiological and cognitive performances, and CV, cerebrovascular and metabolic health. Four studies found improvements in physiological performance (time to exhaustion) following dietary NO₃- supplementation in older adults. Benefits on cognitive performance were unclear. Six studies reported improvements in CV health (blood pressure and blood flow), while six found no improvement. One study showed improvements in cerebrovascular health and two found no improvement in metabolic health. The current literature indicates positive effects of dietary NO₃- supplementation in older adults on physiological performance, with some evidence indicating benefits on cardiovascular and cerebrovascular health. Effects on cognitive performance were mixed and studies on metabolic health indicated no benefit. However, there has been limited research conducted on the effects of dietary NO₃- supplementation in older adults, thus, further study, utilising a randomised, double-blind, control trial design, is warranted.

Keywords: beetroot juice; blood pressure; cardiovascular; cognition; nitric oxide; older adults.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Aging / metabolism*
  • Beta vulgaris / chemistry*
  • Blood Pressure / drug effects*
  • Cardiovascular Diseases / metabolism
  • Cerebrovascular Circulation / drug effects*
  • Cognition / drug effects*
  • Dietary Supplements*
  • Female
  • Humans
  • Male
  • Metabolic Diseases / metabolism
  • Nitrates / pharmacology*
  • Nitric Oxide / metabolism


  • Nitrates
  • Nitric Oxide