Standardized beet root extract in cardiovascular and exercise performance: a randomized, double blind, placebo controlled, cross over, two group, two period, clinical study to evaulate the efficay and safety

IJIRMS. 2016;1(9):376–83

In today’s world of sports, athletic competition is neck-to-neck. Hence, influence of nutrition on training and/or competition performance is gaining interest. In addition, modern training programs have also started understanding the importance of nutrition in sports because today, athletes need simple, practical and achievable dietary advice to reach their physical goals and out-perform their competitors.

In recent years, nitrate (NO3-) is one such nutritional supplement that has been receiving considerable attention and gaining traction as a health and performance enhancing nutritional supplement. This is because of the fact that it is a naturally occurring anion that gets converted into nitric oxide (NO), an important physiological signaling molecule, known to play number of important roles in vascular and metabolic control.

Beetroot is a rich source of NO3- and several studies have reported that it is a powerful dietary source of health-promoting agents for several pathological disorders. In addition, recent research has shown that beetroot supplementation may improve various aspects of physical endurance and produce ergogenic effects in athletes and/or different sport personnel.


To evaluate safety and efficacy of standardized beet root extract in terms of cardiovascular and exercise performance in healthy volunteers.

Study Design:
  • Twenty healthy male volunteers (age: 18–55 years), who were physically active but not exercise trained and normotensive were enrolled in this randomized, double-blind, placebo-controlled, cross-over, two-group and two-period study
  • Subjects were grouped into 10 pairs (n=20), and one member of each pair was randomly assigned to receive Sabeet® supplementation (n= 10), while matched counterpart received placebo (n= 10)
  • During phase I, subjects were instructed to self–administer one sachet (5 g each) containing Sabeet® (standardized beetroot extract containing 2% nitrates) each day for 14 days
  • During phase II, the treatment was crossed over for another 14 days, after a washout period of 7 days
  • Efficacy outcome were change in standing blood pressure, heart rate, stroke volume and cardiac output, ESR and Hs-CRP, plasma nitric oxide (NO) levels, lactate dehydrogenase tests
Results and Discussion:
  • A statistically significant improvement in the cardiovascular and exercise performance was observed between the placebo and Sabeet® arms from baseline to final visit
  • Plasma NO level was found to be lower post-exercise (p<0.05) vs. pre-exercise bout, whereas no such difference was observed in placebo group. These results indicate that supplementary Sabeet® increases circulating NO levels, thus leading to improved blood flow, muscle “pump”, and exercise performance (Fig. 1)
  • Similarly, decreased lactate dehydrogenase (LDH) level was observed in the Sabeet® arm post-exercise vs. pre-exercise (p<0.05). Based on these data it was inferred that supplementation with Sabeet® was able to decrease serum concentrations of the intramuscular enzyme LDH following exercise, thus reducing associated muscle damage (Fig. 2)
  • Significant change in hs-CRP and ESR, measures of inflammatory status, in Sabeet® group post-exercise (p<0.05) compared to per-exercise suggested that consumption of Sabeet® might be able to lower the inflammatory status of healthy adults
  • There were no adverse effects reported during the study period

Sabeet® may be considered as a dietary supplement for improved cardiovascular performance and can be beneficial in enhancing exercise performance due to its protective role against muscle damage.