{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:08:17Z","timestamp":1791655697449,"version":"4.3.4"},"reference-count":96,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gensan SrL, Pisa, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Nitric oxide (NO) is a key mediator of vascular, metabolic, and redox pathways, influencing exercise performance. Beetroot, a natural source of inorganic nitrate, increases NO bioavailability and may modulate oxidative stress and inflammation, though data in endurance athletes remain limited. The aim of this study was to assess the effects of a novel beetroot-based nitrate supplement (B-bNs) on NO metabolism, oxidative stress, and inflammation in non-professional triathletes. Methods: This was a randomized 2 \u00d7 2 cross-over pilot study with two 7-day periods (B-bNs vs. No treatment), separated by a 15-day washout (4 visits: Day 1, 7, 22 and 28). Samples were collected at baseline (T0), 2 h post-first dose (T1), and after 7 days (T2) for the supplementation period (B-bNs) and at T0 and T2 for the \u201cno treatment\u201d period. The following biomarkers from plasma and urine were evaluated: NO pathway (NO metabolites (NOx), nitrite (NO2), inducible nitric oxide synthase (iNOS), peroxynitrite, 3-nitrotyrosine (3-NT)), oxidative stress (reactive oxygen species (ROS) production, 8-isoprostane, superoxide dismutase (SOD) activity), and cytokines (IL-6, IL-10). A total of 10 male triathletes (mean age 48.1 \u00b1 9.8 years and BMI 23.9 \u00b1 2.2 kg\/m2) participated in this study. Results: No adverse events were reported. After 7 days of supplementation (T2 vs. T0), significant increases in NOx in plasma and urine (about +155%), iNOS (+56%), peroxynitrite (+60%), 3-NT (+8.6%), ROS (+413%) and IL-6 (+73%) were recorded. These values resulted significantly higher compared to \u201cno treatment\u201d (all p = 0.002), with no significant differences for 3-NT, SOD, 8-isoprostane, IL-6, and IL-10. Conclusions: Beetroot-based nitrate supplementation may enhance the NO-related pathway in non-professional endurance athletes with nitric-peroxydation activation, occurring without evidence of lipid oxidative damage. Larger placebo-controlled trials with standardized diet\/training and performance outcomes are needed to determine the functional significance of these preliminary findings. This study was registered in the ISRCTN registry (ISRCTN10885376).<\/jats:p>","DOI":"10.3390\/nu18081215","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T07:29:29Z","timestamp":1776065369000},"page":"1215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Beetroot Nitrate Supplementation on Nitric Oxide Pathways and Oxy-Inflammatory Biomarkers in Amateur Triathletes: A Randomized Cross-Over Pilot Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7359-2690","authenticated-orcid":false,"given":"Simona","family":"Mrakic-Sposta","sequence":"first","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell\u2019Ospedale Maggiore, 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-163X","authenticated-orcid":false,"given":"Alessandra","family":"Vezzoli","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell\u2019Ospedale Maggiore, 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Parenza","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Giuseppe Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Magno","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Giuseppe Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"D\u2019Angelo","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Giuseppe Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Nannipieri","sequence":"additional","affiliation":[{"name":"Medical Research, Abiogen Pharma, Via Antonio Meucci, 36, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9591-1046","authenticated-orcid":false,"given":"Santina","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Medical Research, Abiogen Pharma, Via Antonio Meucci, 36, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Solfanelli","sequence":"additional","affiliation":[{"name":"Medical Research, Abiogen Pharma, Via Antonio Meucci, 36, 56121 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1438-7595","authenticated-orcid":false,"given":"Edoardo","family":"Tacconi","sequence":"additional","affiliation":[{"name":"Private Practice, Via Matteo Degli Organi 1, 59100 Prato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Dellanoce","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell\u2019Ospedale Maggiore, 3, 20162 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5152-761X","authenticated-orcid":false,"given":"Michela","family":"Montorsi","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell\u2019Ospedale Maggiore, 3, 20162 Milan, Italy"},{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta, 247, 00166 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1758-5485","authenticated-orcid":false,"given":"Lorenza","family":"Pratali","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council (IFC-CNR), Via Giuseppe Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2303259","DOI":"10.1002\/advs.202303259","article-title":"Nitric Oxide: Physiological Functions, Delivery, and Biomedical Applications","volume":"10","author":"Andrabi","year":"2023","journal-title":"Adv. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1469-7793.1998.577bn.x","article-title":"Effect of Nitric Oxide on Single Skeletal Muscle Fibres from the Mouse","volume":"509","author":"Andrade","year":"1998","journal-title":"J. Physiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.bcmd.2004.02.002","article-title":"Emerging Role of Nitrite in Human Biology","volume":"32","author":"Dejam","year":"2004","journal-title":"Blood Cells Mol. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dom\u00ednguez, R., Garnacho-Casta\u00f1o, M.V., Cuenca, E., Garc\u00eda-Fern\u00e1ndez, P., Mu\u00f1oz-Gonz\u00e1lez, A., de Jes\u00fas, F., Lozano-Estevan, M.D.C., Fernandes da Silva, S., Veiga-Herreros, P., and Mat\u00e9-Mu\u00f1oz, J.L. (2017). Effects of Beetroot Juice Supplementation on a 30-s High-Intensity Inertial Cycle Ergometer Test. Nutrients, 9.","DOI":"10.3390\/nu9121360"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.niox.2020.12.004","article-title":"Beet on Alps: Time-Course Changes of Plasma Nitrate and Nitrite Concentrations during Acclimatization to High-Altitude","volume":"107","author":"Rasica","year":"2021","journal-title":"Nitric Oxide"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Leveque, C., Mrakic Sposta, S., Theunissen, S., Germonpr\u00e9, P., Lambrechts, K., Vezzoli, A., Gussoni, M., Levenez, M., Laf\u00e8re, P., and Guerrero, F. (2023). Oxidative Stress Response Kinetics after 60 Minutes at Different Levels (10% or 15%) of Normobaric Hypoxia Exposure. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241210188"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Koz\u0142owska, L., Mizera, O., Gromadzi\u0144ska, J., Janasik, B., Miko\u0142ajewska, K., Mr\u00f3z, A., and W\u0105sowicz, W. (2020). Changes in Oxidative Stress, Inflammation, and Muscle Damage Markers Following Diet and Beetroot Juice Supplementation in Elite Fencers. Antioxidants, 9.","DOI":"10.3390\/antiox9070571"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.humimm.2013.06.009","article-title":"3-Nitrotyrosine: A Biomarker of Nitrogen Free Radical Species Modified Proteins in Systemic Autoimmunogenic Conditions","volume":"74","author":"Ahsan","year":"2013","journal-title":"Hum. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1159\/000046880","article-title":"Mitochondria in Exercise-Induced Oxidative Stress","volume":"10","author":"Venditti","year":"2001","journal-title":"Biol. Signals Recept."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/S0891-5849(98)00338-4","article-title":"Potential Roles of Myoglobin Autoxidation in Myocardial Ischemia-Reperfusion Injury","volume":"26","author":"Gunther","year":"1999","journal-title":"Free Radic. Biol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"637S","DOI":"10.1093\/ajcn\/72.2.637S","article-title":"Antioxidants: What Role Do They Play in Physical Activity and Health?12","volume":"72","author":"Clarkson","year":"2000","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3846122","DOI":"10.1155\/2021\/3846122","article-title":"Effects of Exercise-Induced ROS on the Pathophysiological Functions of Skeletal Muscle","volume":"2021","author":"Wang","year":"2021","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ito, F., Sono, Y., and Ito, T. (2019). Measurement and Clinical Significance of Lipid Peroxidation as a Biomarker of Oxidative Stress: Oxidative Stress in Diabetes, Atherosclerosis, and Chronic Inflammation. Antioxidants, 8.","DOI":"10.3390\/antiox8030072"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"370","DOI":"10.9758\/cpn.2023.21.2.370","article-title":"Serum Levels of 8-Iso-Prostaglandin F2\u03b1 and Raftlin in Patients with Generalized Anxiety Disorder","volume":"21","author":"Kurutas","year":"2023","journal-title":"Clin. Psychopharmacol. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1152\/japplphysiol.00164.2004","article-title":"The Anti-Inflammatory Effect of Exercise","volume":"98","author":"Petersen","year":"2005","journal-title":"J. Appl. Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/thx.2004.030635","article-title":"Origin of Nitrite and Nitrate in Nasal and Exhaled Breath Condensate and Relation to Nitric Oxide Formation","volume":"60","author":"Marteus","year":"2005","journal-title":"Thorax"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1038\/nrd2466","article-title":"The Nitrate-Nitrite-Nitric Oxide Pathway in Physiology and Therapeutics","volume":"7","author":"Lundberg","year":"2008","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1161\/HYPERTENSIONAHA.107.103523","article-title":"Acute Blood Pressure Lowering, Vasoprotective, and Antiplatelet Properties of Dietary Nitrate via Bioconversion to Nitrite","volume":"51","author":"Webb","year":"2008","journal-title":"Hypertension"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gonzalez, A.M., Townsend, J.R., Pinzone, A.G., and Hoffman, J.R. (2023). Supplementation with Nitric Oxide Precursors for Strength Performance: A Review of the Current Literature. Nutrients, 15.","DOI":"10.3390\/nu15030660"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.niox.2022.01.005","article-title":"Role of Nitric Oxide in Convective and Diffusive Skeletal Muscle Microvascular Oxygen Kinetics","volume":"121","author":"Poole","year":"2022","journal-title":"Nitric Oxide"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Dom\u00ednguez, R., Cuenca, E., Mat\u00e9-Mu\u00f1oz, J.L., Garc\u00eda-Fern\u00e1ndez, P., Serra-Paya, N., Estevan, M.C.L., Herreros, P.V., and Garnacho-Casta\u00f1o, M.V. (2017). Effects of Beetroot Juice Supplementation on Cardiorespiratory Endurance in Athletes. A Systematic Review. Nutrients, 9.","DOI":"10.3390\/nu9010043"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1016\/j.numecd.2012.03.013","article-title":"Endothelial Function and the Regulation of Muscle Protein Anabolism in Older Adults","volume":"23","author":"Timmerman","year":"2013","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.2147\/COPD.S473397","article-title":"Dietary Beetroot Juice\u2014Effects in Patients with COPD: A Review","volume":"19","author":"Chen","year":"2024","journal-title":"Int. J. Chronic. Obs. Pulmon Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"830","DOI":"10.3945\/an.117.016717","article-title":"The Nitrate-Independent Blood Pressure\u2013Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis","volume":"8","author":"Bahadoran","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e14574","DOI":"10.14814\/phy2.14574","article-title":"Acute Beetroot Juice Supplementation Improves Exercise Tolerance and Cycling Efficiency in Adults with Obesity","volume":"8","author":"Behrens","year":"2020","journal-title":"Physiol. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2236060","DOI":"10.1080\/15502783.2023.2236060","article-title":"Effects of Dietary Supplements on Athletic Performance in Elite Soccer Players: A Systematic Review","volume":"20","author":"Abreu","year":"2023","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1249\/MSS.0b013e31828e885c","article-title":"Effects of Nitrate on the Power-Duration Relationship for Severe-Intensity Exercise","volume":"45","author":"Kelly","year":"2013","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Burgos, J., Viribay, A., Fern\u00e1ndez-L\u00e1zaro, D., Calleja-Gonz\u00e1lez, J., Gonz\u00e1lez-Santos, J., and Mielgo-Ayuso, J. (2021). Combined Effects of Citrulline Plus Nitrate-Rich Beetroot Extract Co-Supplementation on Maximal and Endurance-Strength and Aerobic Power in Trained Male Triathletes: A Randomized Double-Blind, Placebo-Controlled Trial. Nutrients, 14.","DOI":"10.3390\/nu14010040"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s40279-016-0617-7","article-title":"The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis","volume":"47","author":"McMahon","year":"2017","journal-title":"Sports Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1249\/MSS.0000000000002363","article-title":"Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-Analysis","volume":"52","author":"Senefeld","year":"2020","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.freeradbiomed.2024.07.004","article-title":"Effects of Increased Nitrate Intake from Beetroot Juice on Blood Markers of Oxidative Stress and Inflammation in Older Adults with Hypertension","volume":"222","author":"Fejes","year":"2024","journal-title":"Free Radic. Biol. Med."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Manful, C.F., Fordjour, E., Subramaniam, D., Sey, A.A., Abbey, L., and Thomas, R. (2025). Antioxidants and Reactive Oxygen Species: Shaping Human Health and Disease Outcomes. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26157520"},{"key":"ref_33","first-page":"243","article-title":"Dietary Nitrate Supplementation Very Slightly Mitigates the Oxidative Stress Induced by High-Intensity Training Performed in Normobaric Hypoxia","volume":"42","author":"Sousa","year":"2025","journal-title":"Biol. Sport."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"134989","DOI":"10.1016\/j.foodchem.2022.134989","article-title":"Effect of Two-Week Red Beetroot Juice Consumption on Modulation of Gut Microbiota in Healthy Human Volunteers\u2014A Pilot Study","volume":"406","author":"Wang","year":"2023","journal-title":"Food Chem."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1017\/S0950268812002233","article-title":"Raw Grated Beetroot Linked to Several Outbreaks of Sudden-Onset Gastrointestinal Illness, Finland 2010","volume":"141","author":"Jacks","year":"2013","journal-title":"Epidemiol. Infect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1477-7525-6-12","article-title":"Reliability and Validity of the Gastrointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) Questionnaire in Dyspepsia: A Six-Country Study","volume":"6","author":"Kulich","year":"2008","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1093\/jn\/nxab354","article-title":"Pharmacokinetic Profile of Incremental Oral Doses of Dietary Nitrate in Young and Older Adults: A Crossover Randomized Clinical Trial","volume":"152","author":"Capper","year":"2022","journal-title":"J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s40279-025-02194-6","article-title":"Dietary Nitrate Supplementation and Exercise Performance: An Umbrella Review of 20 Published Systematic Reviews with Meta-Analyses","volume":"55","author":"Poon","year":"2025","journal-title":"Sports Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tan, R., Pennell, A., Karl, S.T., Cass, J.K., Go, K., Clifford, T., Bailey, S.J., and Perkins Storm, C. (2023). Effects of Dietary Nitrate Supplementation on Back Squat and Bench Press Performance: A Systematic Review and Meta-Analysis. Nutrients, 15.","DOI":"10.3390\/nu15112493"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3562","DOI":"10.1519\/JSC.0000000000004101","article-title":"Effects of Nitrate Supplementation on Muscle Strength and Mass: A Systematic Review","volume":"36","author":"Anderson","year":"2022","journal-title":"J. Strength Cond. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/j.1365-2125.2012.04420.x","article-title":"Vascular Effects of Dietary Nitrate (as Found in Green Leafy Vegetables and Beetroot) via the Nitrate-Nitrite-Nitric Oxide Pathway","volume":"75","author":"Lidder","year":"2013","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"G1061","DOI":"10.1152\/ajpgi.00289.2007","article-title":"Manipulation of Citrulline Availability in Humans","volume":"293","author":"Robins","year":"2007","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3109\/10717544.2014.938839","article-title":"Exploring Versatile Applications of Cyclodextrins: An Overview","volume":"23","author":"Sharma","year":"2016","journal-title":"Drug Deliv."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.ijcard.2014.09.109","article-title":"N-Acetylcysteine (NAC) Inhibits Renal Nitrite and Nitrate Reabsorption in Healthy Subjects and in Patients Undergoing Cardiac Surgery: Risk of Nitric Oxide (NO) Bioavailability Loss by NAC?","volume":"177","author":"Tsikas","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_45","first-page":"306179","article-title":"A Quantitative Method to Monitor Reactive Oxygen Species Production by Electron Paramagnetic Resonance in Physiological and Pathological Conditions","volume":"2014","author":"Gussoni","year":"2014","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Bosco, G., Vezzoli, A., Brizzolari, A., Paganini, M., Giacon, T.A., Savini, F., Gussoni, M., Montorsi, M., Dellanoce, C., and Mrakic-Sposta, S. (2024). Consumption of Sylimarin, Pyrroloquinoline Quinone Sodium Salt and Myricetin: Effects on Alcohol Levels and Markers of Oxidative Stress-A Pilot Study. Nutrients, 16.","DOI":"10.3390\/nu16172965"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Bosco, G., Paganini, M., Giacon, T.A., Oppio, A., Vezzoli, A., Dellanoce, C., Moro, T., Paoli, A., Zanotti, F., and Zavan, B. (2021). Oxidative Stress and Inflammation, MicroRNA, and Hemoglobin Variations after Administration of Oxygen at Different Pressures and Concentrations: A Randomized Trial. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18189755"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/0003-2697(82)90118-X","article-title":"Analysis of Nitrate, Nitrite, and [15N]Nitrate in Biological Fluids","volume":"126","author":"Green","year":"1982","journal-title":"Anal. Biochem."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2449","DOI":"10.1007\/s00421-019-04224-4","article-title":"Oxidative Stress Assessment in Breath-Hold Diving","volume":"119","author":"Vezzoli","year":"2019","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Levenez, M., Lambrechts, K., Mrakic-Sposta, S., Vezzoli, A., Germonpr\u00e9, P., Pique, H., Virgili, F., Bosco, G., Laf\u00e8re, P., and Balestra, C. (2022). Full-Face Mask Use during SCUBA Diving Counters Related Oxidative Stress and Endothelial Dysfunction. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19020965"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4103\/2319-4170.134084","article-title":"Pros and Cons of Current Approaches for Detecting Peroxynitrite and Their Applications","volume":"37","author":"Chen","year":"2014","journal-title":"Biomed. J."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Leveque, C., Mrakic Sposta, S., Theunissen, S., Germonpr\u00e9, P., Lambrechts, K., Vezzoli, A., Bosco, G., L\u00e9v\u00e9nez, M., Laf\u00e8re, P., and Guerrero, F. (2023). Oxidative Stress Response Kinetics after 60 Minutes at Different (1.4 ATA and 2.5 ATA) Hyperbaric Hyperoxia Exposures. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241512361"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Vezzoli, A., Mrakic-Sposta, S., Dellanoce, C., Montorsi, M., Vietti, D., and Ferrero, M.E. (2023). Chelation Therapy Associated with Antioxidant Supplementation Can Decrease Oxidative Stress and Inflammation in Multiple Sclerosis: Preliminary Results. Antioxidants, 12.","DOI":"10.3390\/antiox12071338"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Montorsi, M., Vezzoli, A., Mrakic Sposta, F., Gussoni, M., Brizzolari, A., Bosco, G., Dellanoce, C., Barassi, A., Picconi, B., and Ranuncoli, C. (2025). Systemic Responses Towards Oxy-Inflammation, Hormones, and Mood in Breast Cancer Survivors: Preliminary Evidences from Dragon Boat Endurance Race. J. Clin. Med., 14.","DOI":"10.3390\/jcm14072532"},{"key":"ref_55","unstructured":"(2026, January 22). Creatinine Urine Level\u2014An Overview | ScienceDirect Topics. Available online: https:\/\/www.sciencedirect.com\/topics\/biochemistry-genetics-and-molecular-biology\/creatinine-urine-level."},{"key":"ref_56","first-page":"3062807","article-title":"Acute Effects of Triathlon Race on Oxidative Stress Biomarkers","volume":"2020","author":"Gussoni","year":"2020","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Nieman, D.C., Sakaguchi, C.A., Williams, J.C., Mulani, F.A., Shivprasad Suresh, P., Omar, A.M., and Zhang, Q. (2024). Beet Supplementation Mitigates Post-Exercise Inflammation. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1408804"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Tian, C., Jiang, Q., Han, M., Guo, L., Huang, R., Zhao, L., and Mao, S. (2025). Effects of Beetroot Juice on Physical Performance in Professional Athletes and Healthy Individuals: An Umbrella Review. Nutrients, 17.","DOI":"10.3390\/nu17121958"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Pinheiro, V.D.S., Junior, O.J.F.R., Ortmann, C.F., Pande, A., Conte-Junior, C.A., and Alvares, T.S. (2024). Evaluation of 12-Week Standardized Beetroot Extract Supplementation in Older Participants: A Preliminary Study of Human Health Safety. Nutrients, 16.","DOI":"10.3390\/nu16121942"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1186\/s13063-023-07519-2","article-title":"Efficacy of Beetroot Juice on Reducing Blood Pressure in Hypertensive Adults with Autosomal Dominant Polycystic Kidney Disease (BEET-PKD): Study Protocol for a Double-Blind, Randomised, Placebo-Controlled Trial","volume":"24","author":"Sagar","year":"2023","journal-title":"Trials"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3045","DOI":"10.1016\/j.ekir.2024.07.017","article-title":"Randomized Trial of Nitrate-Replete Beetroot Juice on Blood Pressure in Hypertensive Adults with ADPKD","volume":"9","author":"Sagar","year":"2024","journal-title":"Kidney Int. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1152\/physrev.00029.2006","article-title":"Nitric Oxide and Peroxynitrite in Health and Disease","volume":"87","author":"Pacher","year":"2007","journal-title":"Physiol. Rev."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1006\/bbrc.1993.2079","article-title":"The Reaction of Nitric Oxide with Organic Peroxyl Radicals","volume":"195","author":"Padmaja","year":"1993","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1021\/ar300234c","article-title":"Protein Tyrosine Nitration: Biochemical Mechanisms and Structural Basis of Functional Effects","volume":"46","author":"Radi","year":"2013","journal-title":"Acc. Chem. Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1021\/tx800463y","article-title":"Mechanisms of Peroxynitrite Mediated Nitration of Tyrosine","volume":"22","author":"Gunaydin","year":"2009","journal-title":"Chem. Res. Toxicol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1152\/japplphysiol.00722.2009","article-title":"Dietary Nitrate Supplementation Reduces the O2 Cost of Low-Intensity Exercise and Enhances Tolerance to High-Intensity Exercise in Humans","volume":"107","author":"Bailey","year":"2009","journal-title":"J. Appl. Physiol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"R1121","DOI":"10.1152\/ajpregu.00206.2010","article-title":"Acute and Chronic Effects of Dietary Nitrate Supplementation on Blood Pressure and the Physiological Responses to Moderate-Intensity and Incremental Exercise","volume":"299","author":"Vanhatalo","year":"2010","journal-title":"Am. J. Physiol.-Regul. Integr. Comp. Physiol."},{"key":"ref_68","first-page":"1","article-title":"Dietary Nitric Oxide Precursors and Exercise Performance","volume":"29","author":"Jones","year":"2016","journal-title":"Sports Sci. Exch."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1152\/japplphysiol.00662.2014","article-title":"Acute Dietary Nitrate Supplementation Enhances Compensatory Vasodilation during Hypoxic Exercise in Older Adults","volume":"118","author":"Casey","year":"2015","journal-title":"J. Appl. Physiol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Arazi, H., and Eghbali, E. (2021). Possible Effects of Beetroot Supplementation on Physical Performance Through Metabolic, Neuroendocrine, and Antioxidant Mechanisms: A Narrative Review of the Literature. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.660150"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/joim.12441","article-title":"Therapeutic Effects of Inorganic Nitrate and Nitrite in Cardiovascular and Metabolic Diseases","volume":"279","author":"Omar","year":"2016","journal-title":"J. Intern. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/s41580-020-0230-3","article-title":"Reactive Oxygen Species (ROS) as Pleiotropic Physiological Signalling Agents","volume":"21","author":"Sies","year":"2020","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0074-7696(08)61568-5","article-title":"Roles of Reactive Oxygen Species: Signaling and Regulation of Cellular Functions","volume":"188","author":"Gamaley","year":"1999","journal-title":"Int. Rev. Cytol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Jones, T., Dunn, E.L., Macdonald, J.H., Kubis, H.-P., McMahon, N., and Sandoo, A. (2019). The Effects of Beetroot Juice on Blood Pressure, Microvascular Function and Large-Vessel Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Pilot Study in Healthy Older Adults. Nutrients, 11.","DOI":"10.3390\/nu11081792"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1152\/japplphysiol.00371.2019","article-title":"Influence of Dietary Inorganic Nitrate on Blood Pressure and Vascular Function in Hypertension: Prospective Implications for Adjunctive Treatment","volume":"127","author":"Broxterman","year":"2019","journal-title":"J. Appl. Physiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1161\/HYPERTENSIONAHA.110.153536","article-title":"Inorganic Nitrate Supplementation Lowers Blood Pressure in Humans: Role for Nitrite-Derived NO","volume":"56","author":"Kapil","year":"2010","journal-title":"Hypertension"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.niox.2021.06.002","article-title":"The Effect of Beetroot Inorganic Nitrate Supplementation on Cardiovascular Risk Factors: A Systematic Review and Meta-Regression of Randomized Controlled Trials","volume":"115","author":"Bahrami","year":"2021","journal-title":"Nitric Oxide"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1002\/j.2040-4603.2011.tb00348.x","article-title":"Reactive Oxygen Species: Impact on Skeletal Muscle","volume":"1","author":"Powers","year":"2011","journal-title":"Compr. Physiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1007\/s13105-018-0633-1","article-title":"Effects of Reactive Oxygen Species and Interplay of Antioxidants during Physical Exercise in Skeletal Muscles","volume":"74","author":"Thirupathi","year":"2018","journal-title":"J. Physiol. Biochem."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1139\/apnm-2016-0525","article-title":"Minimal Muscle Damage after a Marathon and No Influence of Beetroot Juice on Inflammation and Recovery","volume":"42","author":"Clifford","year":"2017","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"R453","DOI":"10.1016\/j.cub.2014.03.034","article-title":"ROS Function in Redox Signaling and Oxidative Stress","volume":"24","author":"Schieber","year":"2014","journal-title":"Curr. Biol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"a029793","DOI":"10.1101\/cshperspect.a029793","article-title":"Skeletal Muscle as an Endocrine Organ: The Role of Myokines in Exercise Adaptations","volume":"7","author":"Hoffmann","year":"2017","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1038\/cr.2010.178","article-title":"Crosstalk of Reactive Oxygen Species and NF-\u03baB Signaling","volume":"21","author":"Morgan","year":"2011","journal-title":"Cell Res."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Nyakayiru, J., Jonvik, K.L., Trommelen, J., Pinckaers, P.J.M., Senden, J.M., van Loon, L.J.C., and Verdijk, L.B. (2017). Beetroot Juice Supplementation Improves High-Intensity Intermittent Type Exercise Performance in Trained Soccer Players. Nutrients, 9.","DOI":"10.3390\/nu9030314"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1080\/10408398.2020.1746629","article-title":"The Benefits and Risks of Beetroot Juice Consumption: A Systematic Review","volume":"61","author":"Zamani","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1093\/cvr\/cvq325","article-title":"Roles of Dietary Inorganic Nitrate in Cardiovascular Health and Disease","volume":"89","author":"Lundberg","year":"2011","journal-title":"Cardiovasc. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"5430","DOI":"10.1111\/1750-3841.16365","article-title":"A Randomized Clinical Trial of Beetroot Juice Consumption on Inflammatory Markers and Oxidative Stress in Patients with Type 2 Diabetes","volume":"87","author":"Karimzadeh","year":"2022","journal-title":"J. Food Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.niox.2023.05.005","article-title":"Short-Term Beetroot Juice Supplementation Improves Muscle Speed and Power but Does Not Reduce Blood Pressure or Oxidative Stress in 65-79 y Old Men and Women","volume":"138\u2013139","author":"Zoughaib","year":"2023","journal-title":"Nitric Oxide"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/07315724.2020.1735571","article-title":"Chronic Beetroot Juice Supplementation Accelerates Recovery Kinetics Following Simulated Match Play in Soccer Players","volume":"40","author":"Daab","year":"2021","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Nowak, A., Szyma\u0144ska, A., Kwa\u015bniewska, M., Kochan, E., and Lipert, A. (2025). Beetroot Juice Supplementation as a Healthy Aging Strategy Through Improving Physical Performance and Cognitive Functions: A Systematic Review. Nutrients, 17.","DOI":"10.3390\/nu17243954"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Burgos, J., Viribay, A., Calleja-Gonz\u00e1lez, J., Fern\u00e1ndez-L\u00e1zaro, D., Olasagasti-Ibargoien, J., Seco-Calvo, J., and Mielgo-Ayuso, J. (2022). Long-Term Combined Effects of Citrulline and Nitrate-Rich Beetroot Extract Supplementation on Recovery Status in Trained Male Triathletes: A Randomized, Double-Blind, Placebo-Controlled Trial. Biology, 11.","DOI":"10.3390\/biology11010075"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Porcelli, S., Pugliese, L., Rejc, E., Pavei, G., Bonato, M., Montorsi, M., La Torre, A., Rasica, L., and Marzorati, M. (2016). Effects of a Short-Term High-Nitrate Diet on Exercise Performance. Nutrients, 8.","DOI":"10.3390\/nu8090534"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1249\/MSS.0000000000003708","article-title":"BEETter AGING: Short-Term Dietary Nitrate Supplementation Enhances Muscle Contractile Properties in Older But Not in Young Adults","volume":"57","author":"Rasica","year":"2025","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.niox.2023.04.006","article-title":"Nitric Oxide as a Mediator of Exercise Performance: NO Pain NO Gain","volume":"136\u2013137","author":"Allen","year":"2023","journal-title":"Nitric Oxide"},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Husmann, F., Bruhn, S., Mittlmeier, T., Zschorlich, V., and Behrens, M. (2019). Dietary Nitrate Supplementation Improves Exercise Tolerance by Reducing Muscle Fatigue and Perceptual Responses. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00404"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"17160","DOI":"10.3390\/ijms131217160","article-title":"Nitric Oxide in Skeletal Muscle: Role on Mitochondrial Biogenesis and Function","volume":"13","author":"Tengan","year":"2012","journal-title":"Int. J. Mol. Sci."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/8\/1215\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T07:59:07Z","timestamp":1776067147000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/8\/1215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,12]]},"references-count":96,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["nu18081215"],"URL":"https:\/\/doi.org\/10.3390\/nu18081215","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,12]]}}}