Beyond just being loaded with “artery-clogging saturated fat” and sodium, bacon has been long considered unhealthy due to the use of nitrates and nitrites in the curing process. Many conventional doctors, and well-meaning friends and relatives, will say you’re basically asking for a heart attack or cancer by eating the food many Paleo enthusiasts lovingly refer to as “meat candy”.
The belief that nitrates and nitrates cause serious health problems has been entrenched in popular consciousness and media. Watch this video clip to see Steven Colbert explain how the coming bacon shortage will prolong our lives thanks to reduced nitrates in our diets.
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In fact, the study that originally connected nitrates with cancer risk and caused the scare in the first place has since been discredited after being subjected to a peer review. There have been major reviews of the scientific literature that found no link between nitrates or nitrites and human cancers, or even evidence to suggest that they may be carcinogenic. Further, recent research suggests that nitrates and nitrites may not only be harmless, they may be beneficial, especially for immunity and heart health. Confused yet? Let’s explore this issue further.
Find out why you shouldn’t be concerned about nitrates & nitrites in bacon.
Where Does Nitrate/Nitrite Exposure Come From?
It may surprise you to learn that the vast majority of nitrate/nitrite exposure comes not from food, but from endogenous sources within the body. (1)
When it comes to food, vegetables are the primary source of nitrites. On average, about 93% of nitrites we get from food come from vegetables. It may shock you to learn that one serving of arugula, two servings of butter lettuce, and four servings of celery or beets all have more nitrite than 467 hot dogs. (2) And your own saliva has more nitrites than all of them! So before you eliminate cured meats from your diet, you might want to address your celery intake. And try not to swallow so frequently.
All humor aside, there’s no reason to fear nitrites in your food, or saliva. Recent evidence suggests that nitrites are beneficial for immune and cardiovascular function; they are being studied as a potential treatment for hypertension, heart attacks, sickle cell and circulatory disorders. Even if nitrites were harmful, cured meats are not a significant source, as the USDA only allows 120 parts per million in hot dogs and bacon. Also, during the curing process, most of the nitrite forms nitric oxide, which binds to iron and gives hot dogs and bacon their characteristic pink color. Afterwards, the amount of nitrite left is only about 10 parts per million.
And if you think you can avoid nitrates and nitrites by eating so-called “nitrite- and nitrate-free” hot dogs and bacon, don’t be fooled. These products use “natural” sources of the same chemical like celery and beet juice and sea salt, and are no more free from nitrates and nitrites than standard cured meats. In fact, they may even contain more nitrates and nitrites when cured using “natural” preservatives.
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What Happens When You Eat Nitrates and Nitrites
It’s important to understand that neither nitrate nor nitrite accumulate in body. Ingested nitrate from food is converted into nitrite when it contacts our saliva, and of the nitrate we eat, 25% is converted into salivary nitrite, 20% converted into nitrite, and the rest is excreted in the urine within 5 hours of ingestion. (3) Any nitrate that is absorbed has a very short half-life, disappearing from our blood in under five minutes. (4) Some nitrite in our stomach reacts with gastric contents, forming nitric oxide which may have many beneficial effects. (5, 6) You can listen to my podcast “Does Red Meat Increase Your Risk of Death?” for more information on this topic.
In general, the bulk of the science suggests that nitrates and nitrites are not problematic and may even be beneficial to health. Critical reviews of the original evidence suggesting that nitrates/nitrites are carcinogenic reveals that in the absence of co-administration of a carcinogenic nitrosamine precursor, there is no evidence for carcinogenesis. (7) Newly published prospective studies show no association between estimated intake of nitrite and nitrite in the diet and stomach cancer. (8) Nitric oxide, formed by nitrite, has been shown to have vasodilator properties and may modulate platelet function in the human body, improving blood pressure and reducing heart attack risk. (9, 10, 11) Nitrates may also help boost the immune system and protect against pathogenic bacteria (12, 13, 14)
So what do we take from this? There’s no reason to fear nitrates and nitrites in food. No reason to buy nitrate-free, uncured bacon. No reason to strictly avoid cured meats, particularly those from high quality sources (though it may make sense to limit consumption of them for other reasons). In fact, because of concerns about trichinosis from pork, it makes a lot more sense in my opinion to buy cured bacon and other pork products. I do.
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hi, I know this article is about being able to eat bacon, i am happy about that. I am wondering about advice i received from a dietician here in the netherlands who told me to limit my leafygreens intake to three times a week because of the nitrate/ nitrite issue. I love starting my day with a green smoothie made usually from spinach and this dietician just blew me away.
So, in answer to the question – yes, i will consider reintroducing meat candy to my diet! But please could you address this spinach question? may i return to daily portions of green leafy veggies????
There is quite a bit on the internet, no studies, just a comment, about nitrate in green vegetables being good as a heart disease preventative and a positive influence on athletic performance, as well as a good nutritional profile.
However, large amounts of phytates in raw greens can bind with minerals and remove the minerals from the body, possibly causing an imbalance or just not producing desired results of enhanced nutrition. Thus making the green smoothie concept somewhat redundant.
Cooking reduces phytates, but so does par-boiling and not drinking the cooking water, where most of the phytates remain. If you just love the freshness and flavor of green smoothies and don’t have a problem with stones, or worry of concern about forming stones, then consider the smoothie as a treat and add those minerals later in your diet. However, if you love the flavor and are concerned with stones, mineral intake and want the highest nutritional benefit, consider quickly par-boiling the green leafie and adding it to your green smoothie. There is no research that I am aware of as far as time needed to reduce the phytates when par-boiling. I personally take my electric water heater, pour the hot water over the greens in a bowl, stir quickly until the water becomes slightly green, then add to the smoothie. The short amount of time retains the character and doesn’t create a cooked flavor and is still tastes good in the smoothie. In this case rely on your other fresh veggies or fruits for your enzymes, etc.
A solution to stay within your Dr.’s recommendations and still enjoy. However, if you have a specific health concern being addressed and have a sensitivity to natural nitrates, as you mentioned specifically nitrates, then please ignore the above idea. However, I would further question your Dr. so you can fully understand the specific reason to your individual health as to why nitrates could be harmful in your circumstance.
The irony of an (otherwise seemingly well rereaearched) article debunking one misconception while perpetuating another is amusing.
Trichinosis has not been a serious concern for commercial pork in over a decade. Of the very few cases (fewer than 10 a year) reported in the US, almost all trace back to eating game meats, not farmed pork.
Stop ruining your pork and enjoy it cooked to medium with a slight pink hue in the middle!
Hi Chris,
Your dismissal of epidemiological evidence is disconcerting.
What type of evidence do you look for in drawing your conclusions?
I did not dismiss it. I said it can’t be relied upon to prove causality, especially when it uses food frequency questionnaires (FFQs) which have been proven to be highly unreliable.
In any event, it’s a moot point in this case since the review paper I cited clearly shows that the epidemiological evidence doesn’t support a link between nitrites, nitrates, nitrosamines and cancer.
This meta-analysis of 40 studies (http://aje.oxfordjournals.org/content/166/12/1468.long) is not consistent with your view of FFQs being proven to be highly unreliable.
I would also draw your attention to the following studies:
Nitrates inhibit iodine uptake in the thyroid (promote hypothyroidosis?) and increase the risk of thyroid cancer in males (2011, large prospective study). http://www.ncbi.nlm.nih.gov/pubmed/20824705
Association between cured meat consumption during pregnancy and risk of childhood brain tumors (2004, meta-analysis). http://www.ncbi.nlm.nih.gov/pubmed/14739572
Association between nitrosamine and risk of gastric cancer (2006, systematic review). http://www.ncbi.nlm.nih.gov/pubmed/16865769
Association between nitrite intake and ovarian cancer – 30% increase in highest consumers (2012, large prospective study) http://www.ncbi.nlm.nih.gov/pubmed/21934624
http://www.ncbi.nlm.nih.gov/pubmed/22889895
Re: FFQs, see:
Relative Validity of Food Intake Estimates Using a Food Frequency Questionnaire Is Associated with Sex, Age, and Other Personal Characteristics
http://jn.nutrition.org/content/136/2/459.full
People with diagnosed medical conditions tend to over-estimate their consumption of meat and processed meat products (nutrition.org/content/136/2/459/T3.expansion.html). This could certainly affect the results of epidemiological studies examining relationships between processed meat consumption and cancer, since people with medical conditions involving oxidative damage and inflammation are at higher risk for cancer. It also means that meat consumption will be inaccurately associated with disease in general.
The potential for confounding in these studies is also extremely high. Investigators can only control for so many factors, and they only control for those they believe are worth controlling for. I have not yet seen a study on processed meat consumption that controls for processed & refined carbohydrates, for example. Most people eat hot dogs with buns; how do we know it’s the hot dog and not the bun causing problems? And of course there are more obvious confounding factors that are often not controlled for, like average calorie intake, physical activity, etc. etc.
Then there’s the question of mechanism. If nitrates, nitrites and nitrosamines aren’t in fact associated with cancer, as the review above suggests, what is the mechanism by which processed meats cause cancer?
The medical establishment still advises people to avoid saturated fat because it causes heart disease, on the basis of limited epidemiological data. But recent studies (like this: http://ajcn.nutrition.org/cgi/content/abstract/ajcn.2009.27725v1) have shown that there is no association between saturated fat consumption and CVD.
I think we have to be very careful about drawing conclusions from epidemiological data for this reason.
The possible confounders in studies that find an association with high saturated fat consumption and CVD include refined carbohydrate intake, sedentary lifestyle and genetic predisposition to hypercholesterolemia and related risk factors. However, this does not mean that such studies have no value. On the contrary, they provide evidence that in individuals on high carb diets, high levels of saturated fat will increase CVD risk.
In any case, there is now a reasonable volume of epidemiological data to suggest that caution should be exercised in the intake of meats cured with nitrites that have the potential to generate carcinogenic nitrosamines. In view of the fact that there is no health benefit to the consumption of cured meats to offset such potential risk, it is disingenuous to promote them as a health food.
Sorry, I’ll have to disagree with your view of epidemiological studies. They, in all cases, cannot be used at all to ‘suggest’, ‘provide evidence’, or anything that might be interpreted as causing any effect, period. To use them thus is a travesty of rational thought. Basically they have very limited scientific utility. All that they can do is to say, “these effects were found in this group under these circumstances, with the caveats that 1) there are many unaccounted-for and in fact unknown confounders; 2) the data is suspect due to the way it was gathered; 3) any causal suggestions are totally conjectural; 4) science journalists should understand that research conclusions herein using words such as ‘linked to’, ‘associated with’, ‘shows’, ‘may be’, all are used in a scientific sense that is quite different from the usage by the man on the street, who thinks, not unreasonably, that these terms imply causality; and that 5) since this is an epidemiological study, it is by definition almost worthless, and should only be used to encourage debate and actual experimentation.”
The above caveat should be required in publications (good luck with that.) The problem is many scientists have made a living at data-mining the old, long-term studies for new papers for so long, the methodology is very entrenched. And unfortunately, it does not lead to good experiments as often as it should, so the original ‘conclusions’, no matter how unjustified, hang in the scientific & public consciousness for a long time.
It appears to be a prevailing attitude amongst those who espouse fringe, unorthodox and often clinically ineffectual health practices that the medical and scientific community is conspiring against the individual and that it’s conclusions should not be trusted. A common argument to invoke is that – despite mountains of data to the contrary – it must be a particular type of study only that can provide evidence of causality and if such a study cannot be found then that constitutes proof of no association.
To suggest that epidemiological studies are worthless – especially in the light of no evidence to support such a claim, other than a personal opinion and a play at semantics – is as preposterous as it is dangerous for those who would take such comments to heart and alter their dietary practices and ultimately their health.
Such views are, of course, untenable and it is regrettable that they take root in the minds of vulnerable individuals.
I agree that epidemiological studies are not worthless, but to imply the contrary, which you are getting close to saying, is not tenable. Do you remember this Reuters article on 3/28/2012:
A former researcher at Amgen Inc has found that many basic studies on
cancer — a high proportion of them from university labs — are
unreliable, with grim consequences for producing new medicines in the
future.
During a decade as head of global cancer research at Amgen, C. Glenn
Begley identified 53 “landmark” publications — papers in top journals,
from reputable labs — for his team to reproduce. Begley sought to
double-check the findings before trying to build on them for drug
development.
Result: 47 of the 53 could not be replicated. He described his findings
in a commentary piece published on Wednesday in the journal Nature.
You’ve provided one study and I’ve provided 4 (below). Please note the quality of the studies.
You’ve still not explained why you’re dismissing such compelling epidemiological evidence, which sets into question the basis for your conclusions.
Do you have a list of those who funded the study? And how about who designed it? Was it designed with the outcome in mind?
Ask that for each of the studies you’ve cited, and see where that leads.
It’s the nitrosamines you will want to avoid. Nitrite indeed needs certain conditions to form nitrosames. Like a strong acidic environment. Which you find in the stomach.
A meta-analysis on 16 studies done in Sweden found a connection between processed meats and cancer risk
“”We decided to carry out a meta-analysis. This is an analysis in which we collated all research into processed meats and stomach cancer that we could find”, explains Susanna Larsson, research student under the supervision of Alicja Wolk at The Institute of Environmental Medicine at Karolinska Institutet.
They found 15 studies, covering 4,704 subjects in the period 1966 2006, and the results are unequivocal: the risk of developing stomach cancer increases by between 15% and 38% when consumption of processed meat products increases by 30 grams (approximately a half-portion) per day.” http://ki.se/ki/jsp/polopoly.jsp?d=130&a=15182&l=en&newsdep=130
The results are not at all unequivocal. Read the review paper I cited in this article.
This is literally the dumbest thing I’ve ever read. Sure, it isn’t clear what increases the bowel cancer risk in processed meats like bacon and hot dog products – might be nitrates, might be something else – but the increased bowel cancer risk from those foods is extremely clear in very large studies. The article makes an elementary error in thinking that nitrites in vegetables and saliva are the same as nitrites in meat: this overlooks the possibility of an *interaction* between nitrites, meat and of course, the bowel wall.
If you bothered to read any of the citations I included in the article, you would see that newly published studies *do not* show an association between processed meats and cancer, barring other factors like vitamin C deficiency and/or the presence of h. pylori.
True. But you still didn’t address Daniel’s point about naturally occurung vs those added to foods. I think that is the main issue. We should eat real food not things created by man, like processed meats.
I agree and was going to make that point too…
Agreed bill!!!
http://www.ncbi.nlm.nih.gov/pubmed/22889895
Chris, you have not responded to most of the comments/questions that are very legitimate concerning the nitrosamine precursors suggested: cooking bacon at too high heat/burning it possibly; combining it with coffee at mealtime or foods with amines that cause it to become toxic and carcinogenic; etc. You seem to be avoiding those real questions. Why? There have been quite a few of them in this ongoing list of people’s concerns if you care to read back. I would be very glad to hear your specific response to these specific questions, not just “…if you bothered to read any of the citations I included in the article….” responses. So far I am disappointed and tend to agree with those who choose pastured, non-GMO fed pigs without chemicals and synthetic ingredients, etc.
Kresser has blown all his credibility by not addressing the major concerns and instead deciding to make straw-man arguments. His defense of “GO READ THE STUDY” is equally laughable. Since he didn’t even address the major going concern of nitrates, and these ‘studies’ supposedly did, then we can only infer that Chris Crisco didn’t read it, himself.
You must not read a lot then.
Wouldn’t nitrates from ‘natural’ sources be different, in principle, from those that I assume are syntheticaly constructed? Ie analgous to fructose in fruit or fish as opposed to in HFCS…?
Hey Chris,
You made a seriously persuasive argument here. Although you didn’t change my mind about bacon specifically, you did change how I look at nitrates. Let’s just say that, as I type this, I’m not trying to hold back on swallowing saliva.
Thanks for an excellent piece that definitely needs to be shared. I’ll do my part to pass this along to people who could benefit from it.
Chris, you hinted at the end that you might actually prefer nitrates/nitrite cured products over those that are not. It’s hard to find pasture raised pork that isn’t also nitrate/nitrite free. They usually use a simple, regular salt process. Is that fine? Does it serve the same purpose in regards to the trichinosis.
reminds me of scientists shilling for tobacco companies in the 1950’s
You are allowed to be incorrect.
If you’re going to say that “X-study has been discredited” would you please provide a citation? Otherwise I’ll I can say is “Some guy on the internet said…” and that’s not going to convince anyone, even if that “some guy” is famous or well known.
I liked the article quite a bit, but I’m afraid I can’t pass it around just yet…
Thanks! 🙂
The references are in the article, as they always are.
Interesting. Then I wonder what it is about “regular” bacon that gives me an upset stomach. Everything is a-ok if I eat something like Applegate Farms brand. I thought it was the nitrates/nitrites. My n=1 continues….
Thanks for the article. I passed it on as I do with several of your posts. I eat bacon and was wondering about the nitrates. Not enough to stop eating it though! I will sleep better now that I know the truth. Also, I suggest people sleep on their side or stomach so that the saliva created at night while sleeping doesn’t overdose them!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2409746/
Preserved vegetables are many times more dangerous than preserved meat in this study.
Nitrates and nitrites are oxidizing agents that add electrons to your body. If you have too much of them your body converts Ferrous (easily absorbed iron) to Ferric iron(poorly absorbed iron). Resulting in poor transportation of oxygen in your blood and sometimes anemia. These are found in our water absorbed through fertilizers and other environmental toxins aside from sodium nitrates and nitrites in food.
I thought trichinosis was eradicated? Love pork and bacon BTW, and appreciate the article!
We haven’t had it in New Zealand since 1948 apart from one occasion in the 1970’s.
Apparently (if you believe the web site linked below), beet juice is ‘big’ in the sporting arena for enhancing/boosting performance due to its high natural dietary nitrate, which then raises nitric oxide levels.
http://www.beet-it.com/sport/
Thank you for writing this. I’ve been staying away from high quality bacon and sausages from a local pig farm because of the nitrates, even though the only ingredients in the sausages are : meat, spices, nitrate.
I will definitely feel happier eating them now.
Nice to see someone else in agreement on this overblown fear.
I still can’t eat is because of the migraine factor (chocolate and wine too), and I’m not surprised that the celery salt/seed/juice products actually have more nitrites. I’ve read that elsewhere, but I got an even worse migraine when I missed the word “added” in the phrase “No added nitrates or nitrites!” in some hot dogs a while back. A nasty phone call to the company assured me I wasn’t the only one.
I have to say, I’m jealous. I’d love a couple slices of bacon every now and then, but I’m not willing to spend 3 days in pain to do it.
Good gosh! No bacon, chocolate, or wine? I feel for you sister.
Very interesting – thanks! I do love bacon, but after reading the Perfect Health Diet’s 3-part series on pork, am trying to avoid pork. And with the Omega 6 issue of pork and chicken, I now favor beef, lamb, fish/seafood and eggs. http://perfecthealthdiet.com/2012/02/pork-did-leviticus-117-have-it-right/