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The Study

Lowering salivary pH with sugar-containing gum augments salivary nitrite production and blood pressure reduction with dietary nitrate (beetroot juice).

In simple terms

This study showed that when healthy people chew sugary gum after drinking beetroot juice, their body makes more of a chemical that helps relax blood vessels and lower blood pressure a little bit. But it only happened in a tiny group of young, healthy people for a few hours — it doesn't mean sugary gum is a medicine.

68%

Analysis score

68/ 90

Maximum 90 for a randomized controlled trial.

Where the score came from

Reporting40
Methodology58
Publication100
Statistical77
Study type (basis of the score)
Randomized Controlled Trial
Level 1b - Individual RCT
What’s the bottom line?

When you eat beetroot juice, your body turns it into a chemical that helps relax blood vessels. But first, bacteria in your mouth need to change it — and sugary gum helps them do it better.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
68

68 / 100

Quality score

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

Can establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1A 2.7 mmHg drop in systolic blood pressure is similar to the effect of some blood pressure medications — a meaningful, measurable change in healthy people.
  2. 2Chewing sugary gum after beetroot juice lowered mouth pH by 1.4 units, boosted mouth nitrite by 45%, raised blood nitrite by 25%, and lowered blood pressure by 2.7 mmHg (systolic) and 1.9 mmHg (diastolic).

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

British journal of clinical pharmacology

Year

2026

Authors

A. Webb, H. Clift, Callum Hill, Nureldayim Mousa, Navanithan Arun Jayaraj, Jasmine Quraishi, Charlotte E. Mills, Kevin O’Gallagher

Open Access
Analysis v5

Related Content

Claims (6)

Assertion

In healthy young adults, chewing sugar-containing gum while consuming dietary nitrate causes an additional drop in blood pressure by 2.7 mmHg systolic and 1.9 mmHg diastolic, regardless of changes in nitrate levels in the blood.

Causal
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Assertion

Chewing gum with sugar increases the amount of saliva produced by about 6.3 mL over five minutes compared to sugar-free gum, but does not change the levels of nitrate in the saliva or the total amount of nitrate released, meaning the higher saliva flow is not how nitrite production increases.

Mechanistic
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Assertion

After consuming 400 mg of nitrate from beetroot juice, chewing sugar-containing acidic gum for 6 hours lowers salivary pH by 1.4 units, increases salivary nitrite by 45%, raises plasma nitrite by 25%, and reduces systolic blood pressure by 2.7 mmHg and diastolic blood pressure by 1.9 mmHg in healthy young adults.

Mechanistic
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Assertion

Chewing sugar-containing gum that lowers saliva acidity increases the conversion of dietary nitrate to nitrite by oral bacteria, which raises nitrite levels in the blood and lowers blood pressure shortly after, without altering nitrate levels in saliva or blood.

Mechanistic
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Assertion

In the human body, saliva with lower acidity converts more nitrate to nitrite, while in lab tests with isolated oral bacteria, higher acidity leads to more conversion. The conversion rate depends on whether it occurs in the human body or in a controlled lab setting.

Mechanistic
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Assertion

The amount of nitrite in saliva cannot be used to determine how much nitric oxide is available in the bloodstream or the level of nitrite circulating in the blood.

Descriptive
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