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Are there any concerns or considerations?

  • During the 1960s, health authorities became concerned about the nitrate and nitrite content of foods, blaming nitrite for health issues including “blue baby syndrome” in infants and an increased risk of colon cancer based on studies in rats. As a consequence, some countries have limits on the permitted levels of nitrate in foods and drinking water.
  • In contrast to these previous concerns about the safety of intake of nitrate and nitrite, which are in any case disputed, there is now evidence of benefits to cardiovascular and metabolic health. Indeed, it has been suggested that some of the health benefits of a diet high in vegetables are due, at least in part, to its nitrate content.
  • Consuming nitrate in its natural form (i.e., in vegetables and fruits), where it is found alongside antioxidants and polyphenols, rather than via processed meats, is likely to prevent or suppress the formation of any potentially-harmful compounds.
  • While it is unlikely that consumption of beetroot juice or other vegetable sources of nitrate is harmful (and may, in fact, may offer other health benefits), chronic use of nitrate supplements has not been well studied.
  • Beetroot juice, particularly in concentrated form and larger doses, sometimes causes mild gastrointestinal discomfort. Athletes who are inclined to use nitrate supplementation pre-competition are advised to first practice in training.
  • The consumption of beetroot/juice may cause a temporary pink coloration of urine and stools. This is a harmless side-effect.
  • Use of sodium nitrate supplements may be associated with a greater risk of misjudging dosages. Some athletes may also mistakenly (or deliberately) use sodium or potassium nitrite as a supplement and therefore expose themselves to toxic effects such as methemoglobinaemia.

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