Effect of Beetroot Supplementation Dose on Cardiovascular Health Outcomes: An Integrative Review

Abstract

Introduction: Beetroot supplementation, a dietary source of inorganic nitrate, has been investigated as a non-pharmacological strategy to improve cardiovascular health, mainly by increasing the bioavailability of nitric oxide (NO) through the nitrate–nitrite–nitric oxide pathway. However, there is no consensus on the optimal dose capable of promoting vascular benefits. This integrative review aimed to analyze the relationship between different doses of beetroot supplementation and their effects on blood pressure and endothelial function in different populations. Methodology: The search was performed in the LILACS, PubMed, and CAPES Periodicals databases, resulting in 11 included studies. Doses ranged from 3.26 to 12.8 mmol, administered in acute or chronic protocols. Results: Overall, supplementation promoted consistent improvement in endothelial function, evidenced mainly by increased Flow-Mediated Dilation (FMD), as well as reduced blood pressure in several groups, such as the elderly, postmenopausal women, hypertensive individuals, and individuals with peripheral arterial disease. Populations with greater vascular impairment showed more significant responses. Conclusion: Beetroot supplementation is a promising strategy for optimizing vascular health, with effects dependent on dose and baseline endothelial function. More standardized studies are needed to determine the optimal dosage and its long-term applicability.