Beetroot (Dietary Nitrate), Blood Pressure, and Kidney Stones: What to Know

Reading time: 8–11 minutes • Evidence-informed, educational only.

Beetroot and other nitrate-rich foods (e.g., arugula, spinach, celery) can raise plasma nitrate/nitrite and support nitric-oxide (NO) pathways related to vascular tone. Randomized trials and meta-analyses often show small-to-modest average reductions in blood pressure (BP)—particularly in adults with higher baseline BP—with effects depending on dose, duration, and product (juice vs. concentrate vs. capsules).

How Beetroot May Support Healthy Blood Pressure

• Enterosalivary nitrate–nitrite–NO pathway: Oral bacteria reduce nitrate to nitrite; swallowed nitrite can generate NO and support vasodilation.
• Endothelial & autonomic angles: NO signaling can influence endothelial function and hemodynamics.
• Mouthwash caveat: Strong antiseptic mouthwashes can blunt oral nitrate reduction and have shown small BP increases in healthy adults; time mouthwash away from nitrate-rich meals.

What Research Suggests

• Systematic review/meta-analysis (2022): Nitrate-replete beetroot juice reduced BP by ~3.6 mmHg systolic and ~1.3 mmHg diastolic on average across trials.
• Hypertensive adults—sustained effect: Daily dietary nitrate produced sustained BP reductions and favorable hemodynamics.
• Recent RCT (2024): Four weeks of nitrate-replete beetroot juice lowered systolic BP by ~9 mmHg vs. control in hypertensives.

Beetroot, Oxalate, and Kidney Stones

Why oxalate matters: Most kidney stones are calcium oxalate. For people who form these stones—especially with elevated urinary oxalate—prevention includes adequate fluids, normal dietary calcium with meals to bind oxalate in the gut, and limiting high-oxalate foods when urinary oxalate is high.

Are beets/beet greens high-oxalate? Yes. The National Kidney Foundation classifies beets (tops, roots, greens) among high-oxalate foods; several clinical resources list beets as “high” and advise portion control for calcium-oxalate stone formers.

What about beetroot juice? Oxalate can be concentrated in juices. Lab analyses measured ~60–70 mg oxalate per 100 mL in commercial beetroot juices; another composition study found ~0.3–0.5 g/L (30–50 mg/100 mL) across varieties—brand and method vary. If you’re a stone former, factor this into serving size and frequency.

Practical ways to reduce stone risk if using beetroot

• Fluids: Aim for urine output ≥ 2.5 L/day (your clinician can tailor this).
• Calcium with meals: Get 1,000–1,200 mg/day of dietary calcium and pair calcium-containing foods with oxalate-containing meals to bind oxalate in the gut.
• Portions & frequency: If you choose beetroot, consider smaller portions (e.g., occasional ¼–½ cup cooked beets) and avoid frequent large glasses of beet juice unless cleared by your care team based on 24-hour urine testing. Consult reliable oxalate lists when planning.
• Broader diet levers: Moderate sodium (helps reduce urinary calcium) and animal protein per clinician guidance.

Forms, Dosing & General Usage for BP

Trials typically use standardized juices or concentrates (e.g., ~250–500 mL/day of juice or concentrates delivering ~300–600 mg nitrate) for 2–8+ weeks; capsules/extracts are also studied. If you have a history of kidney stones, integrate the oxalate guidance above and discuss concentrated beet products with your clinician.

Safety & Considerations

• Medication coordination: Because beetroot may lower BP, coordinate with your clinician to avoid additive hypotension with medications.
• Tolerability: Pink/red urine or stool (“beeturia”) is generally benign; GI upset can occur.
• Oral-care timing: If you use antiseptic mouthwash, avoid it near nitrate-rich meals to preserve the enterosalivary pathway.
• Kidney-stone specific: For calcium oxalate stone formers, target urine ≥2.5 L/day, keep normal dietary calcium with meals, and use portions/frequency that fit your personalized plan.

Lifestyle Tie-Ins

Beetroot works best alongside fundamentals (DASH-style eating, sodium/potassium balance, activity, weight management, sleep, stress practices, and adherence to prescribed care). Explore:

• Diet & Lifestyle Pillar
• How to Measure & Track at Home
• Supplement Comparison Hub

FAQs

Bottom Line

Nitrate-rich beetroot can modestly support blood-pressure management—especially for adults with higher baseline BP—when used consistently and paired with lifestyle fundamentals. If you have a history of calcium oxalate stones, keep an eye on oxalate exposure: emphasize fluids (aim for urine ≥2.5 L/day), calcium with meals, and portion control of high-oxalate foods like beets/beet greens; consider alternatives and personalize with clinician guidance and 24-hour urine testing. Beetroot is an adjunct, not a stand-alone therapy.

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Educational Disclaimer: This article is for educational purposes only and is not medical advice.

References

1. Benjamim CJR, et al. Nitrate-derived beetroot juice and blood pressure: systematic review & meta-analysis. 2022. PMC.
2. Kapil V, et al. Dietary nitrate provides sustained BP lowering in hypertensive patients. 2014/2015. PMC.
3. Sagar PS, et al. Randomized trial of nitrate-replete beetroot juice in hypertensives. 2024. PMC.
4. Kapil V, et al. Physiological role for nitrate-reducing oral bacteria in BP control (chlorhexidine raises BP). 2013. Author manuscript PDF.
5. Blot S, et al. Antiseptic mouthwash, the nitrate–nitrite–NO pathway, and risks. 2020. PMC.
6. Pearle MS, et al. Medical Management of Kidney Stones (AUA Guideline). 2014/2019. PubMed.
7. National Kidney Foundation. Kidney Stone Diet Plan & Prevention. NKF.
8. National Kidney Foundation. Calcium oxalate stones—dietary calcium binds oxalate. NKF.
9. Harvard T.H. Chan School of Public Health. Oxalate Table (XLS). Harvard HSPH.
10. UCI Kidney Stone Center. Oxalate Content of Foods. UCI.
11. Siener R, et al. Oxalate in fruit & vegetable juices; beetroot juices 60–70 mg/100 mL. 2016. Abstract.
12. Wruss J, et al. Compositional characteristics of commercial beetroot products; oxalic acid ~0.3–0.5 g/L. 2015. Abstract.