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Randomised, double blind, placebo controlled four way crossover Online publication date confirmed against the PubMed publication date field. No competing print issue date on the record.

A beetroot drink cancelled out the arterial stiffening that caffeine caused

AI narration, generated on first listen
Journal
Food and Function
Authors
McLellan AG, Ahmad NSB, Bailey SJ
Institution
Loughborough University
Published
25 August 2026
Source
PMID 42639731 · DOI 10.1039/d6fo02338j
Design
Randomised, double blind, placebo controlled four way crossover. Nitrate rich and nitrate depleted beetroot powder, each with and without caffeine, with vascular measures taken before and 2.5 hours after supplementation.
Sample
Twenty four healthy participants, 17 male, mean age 24(3) years.

What arterial stiffness is

Arterial stiffness describes how much the large arteries give way when the heart pushes blood into them. One common way to put a number on it is the augmentation index, which captures how much of the peak pressure in each beat comes from the pressure wave bouncing back off the body rather than from the heart's own push. Stiffer arteries send that wave back sooner and harder.

Drawn from background physiology, not from this paper.

Why they ran it

Nitrate supplementation and caffeine have each been reported to push various aspects of cardiovascular function in conflicting directions. The authors set out to test whether taking nitrate alongside caffeine would offset the cardiovascular strain that caffeine imposes.

Drawn from the paper's introduction.

Twenty four healthy participants, seventeen of them male and averaging 24 years, completed four trials in a randomised, double blind, placebo controlled crossover: nitrate rich beetroot powder at 400 mg nitrate and a nitrate depleted version at 92 mg, each taken with and without 6 mg of caffeine per kilogram of body mass. Brachial and central blood pressure and arterial stiffness were measured before and 2.5 hours after supplementation, with flow mediated dilation assessed afterwards.

Caffeine on its own raised both stiffness measures. Augmentation pressure rose by 3(2) mmHg against 1(3) mmHg on placebo and 0(3) mmHg on nitrate alone, and the augmentation index reached 10(9) percent against 4(11) percent on placebo and 1(11) percent on nitrate alone, with p values from less than 0.001 to 0.007.

The combination behaved like placebo. Nitrate taken with caffeine gave an augmentation pressure of 1(3) mmHg and an augmentation index of 3(10) percent, which did not differ from placebo or from nitrate alone at p 0.505 to 0.689.

Nothing else moved. Brachial blood pressure, central blood pressure and flow mediated dilation showed no differences against placebo at p 0.067 to 0.359, and plasma cyclic guanosine monophosphate did not differ between conditions at p 0.370. Plasma nitrite was higher in both nitrate conditions than in placebo and caffeine at p less than 0.001, confirming the supplement was absorbed.

The numbers

Augmentation pressure, caffeine alone+3(2) mmHg vs +1(3) placebo and +0(3) nitrate alone, p<0.001 to 0.007
Augmentation index, caffeine alone10(9)% vs +4(11)% placebo and +1(11)% nitrate alone
Nitrate plus caffeineaugmentation pressure +1(3) mmHg, index +3(10)%, p=0.505 to 0.689 vs placebo and nitrate alone
Doses6 mg/kg caffeine; 400 mg nitrate vs 92 mg nitrate depleted
Brachial BP, central BP, flow mediated dilationno differences vs placebo, p=0.067 to 0.359
Plasma cyclic guanosine monophosphateno difference between conditions, p=0.370
Plasma nitritehigher in both nitrate conditions, p<0.001

Why this might happen

Not available The full discussion is not openly available and the abstract offers no mechanism, so we do not know what the authors think caused this.

Drawn from no open full text was reachable.

What this does not show

  • This does not show that nitrate improves performance. No exercise task was performed. The measurements were vascular readings taken at rest, and no running, riding or work capacity outcome was recorded.
  • This does not show that caffeine harms cardiovascular health. A rise in one stiffness index over two and a half hours in healthy young adults is a transient physiological response, not a disease outcome, and this design cannot connect the two.
  • This does not identify how nitrate offset the effect. Blood pressure, endothelial function and the signalling molecule the authors measured all failed to separate the conditions, so the route from nitrate to the stiffness reading is not established here.
  • This does not tell you about repeated use. Every condition was a single dose assessed once, so nothing follows about what happens when someone takes caffeine daily, with or without nitrate.

Where this leaves us

Two things endurance athletes commonly take on the same morning were shown to interact, with the nitrate drink holding one measure of arterial load at placebo levels when caffeine on its own raised it.

Healthy adults in their twenties, at rest, in a single session.

Nothing about training or racing yet. It moves the question from whether caffeine has a vascular cost to whether that cost matters over a season and whether anything at all changes downstream.

Caveats worth holding

  • Healthy adults averaging 24 years, mostly male, so nothing follows for older or clinical populations.
  • Single acute dose with measurement at 2.5 hours only.
  • No open full text was reachable, so this rests on the abstract.

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