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Do nitrosamines produced in food actually cause cancer?

Answered on September 12, 2014
Created August 02, 2012 at 2:21 AM

Paleo folks love to dote on bacon, but it has to be uncured nitrite/nitrate-free bacon because of those terrible cancer-causing nitrosamines. I'm fully aware that nitrosamines are carcinogenic, but all studies I've seen have been simply spiking animal chow with isolated nitrosamine compounds. Anybody know of a study that shows that nitrosamines produced during cooking in the food matrix also have this cancer-causing property? An animal study showing this effect would be fine. An epidemiological study in humans would not be convincing.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on October 14, 2012
at 02:54 PM

Because I want a study that attempts to show causation, rather than repeatedly showing correlation.

77877f762c40637911396daa19b53094

(78467)

on October 14, 2012
at 12:02 PM

*"An epidemiological study in humans would not be convincing."* -- **why not??**

77877f762c40637911396daa19b53094

(78467)

on October 14, 2012
at 12:01 PM

**An epidemiological study in humans would not be convincing.** -- why not?

77877f762c40637911396daa19b53094

(78467)

on September 30, 2012
at 03:45 AM

And what are the references to the two studies you mention Matt?

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 02, 2012
at 03:25 PM

Jay, epidemiology only gets us so far. I saw reference to a study that found a statistically insignificant link between bacon and cancer, but also found that the same level of correlation existed between chicken breast and cancer.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 02, 2012
at 03:23 PM

Thanks for the thoughtful reply, Mscott. It does appear that the dose humans get from cured meats is well-below what induces cancer in lab animals. Couple this with the idea that the nature of the nitrosamines are different - added vs formed in the food, pure NDMA vs whatever mixture forms during cooking, etc... Heck, I would also assume that differences in digestive system pH and transit time would also affect how carcinogenic these compounds are.

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 02, 2012
at 02:24 PM

But, I don't think liver cancer is necessarily the most likely nitrosamine-induced cancer. Stomach cancer, for example, has been associated with nitrosamines, including from cured meat and, in some studies, from leafy green vegetables....

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 02, 2012
at 02:23 PM

But, I don't think liver cancer isn't necessarily the most likely nitrosamine-induced cancer. Stomach cancer, for example, has been associated with nitrosamines, including from cured meat and, in some studies, from leafy green vegetables....

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on August 02, 2012
at 09:30 AM

Also, this is yet one more time you've made me research and reevaluate my opinion on something, Matt. +1 and thanks for that.

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1 Answers

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A2c38be4c54c91a15071f82f14cac0b3

(12682)

on August 02, 2012
at 09:28 AM

N-nitroso-dimethylamine, or NDMA, is one of the specific nitrosamine that I think is most likely to be cause for concern. NDMA has been found in notable quantities in cured meats and other similar food products. This study found concentrations of about NDMA highest in sausages at about 10 micrograms per 100 grams in sausage. This same study reported bacon as containing about .5 micrograms per 100 grams, but when cooked this number seems to increase.

A study by Richard Peto et al. measured different intakes of NDMA on the health of rats and found that NDMA increased liver cancer. Regarding dose they stated the following; "Since the experiment continued into extreme old age, effects became clearly measurable even at a dose of only 0.01 mg/kg per day". So even .01 mg per kg of body weight increased cancer. And for those doubting the validity of a rat study on humans, look at this:

This graph, taken from this paper, suggests the potential carcinogenic effects of NDMA (via formation of DNA adducts) is similar in rats and humans. Yes, humans are still not rats, but this should make the extrapolation from a rat study slightly more reasonable.

Moving on, let's imagine a real world scenario; if a 65 kg person were to consume a pound of sausages in a day that might give them about 45 micrograms, or .045 mg of NDMA. This would amount would be less for a pound of bacon. The dose of NDMA that still seems to increase liver cancer (via that rat study) for that 65 kg person is .65 mg.

So eating a pound of sausages every day might give you 7% of the dose of NDMA shown to increase liver cancer incidence in rats. Eating a pound of bacon every day would give you much less, probably no more than about 4% of the dose. This is pretty low. So I'm now unconvinced that NDMA makes a few slices of bacon or some pieces of cured meat all that risky. And I really haven't seen much to suggest that other nitrosamines in food are going to increase cancer either.

Anyway, I think this is a good question and hope to hear more people weigh in.

Edit:

My answer is already lengthy, but since this subject has received some attention lately I thought it was due time I updated my answer with additional info.

First, I wanted to briefly point out two issues with using with using rodents to try and determine carcinogenic thresholds for nitrosamines. One the one hand, rodents don't live as long as humans and thus are less able to model long term low dose exposure. On the other hand, rodent diets are typically refined and the likelihood that they contain non-essential phytochemicals is slim to nil. This is important because, at least in rats, garlic, green tea, tomatoes, ellagic acid, and quercetin, among other compounds, have been shown to inhibit the carcinogenic potential of specific nitrosamines. Also, again in rats, the tumor promoting effect of N-nitrosomethylurea (and I would bet most nitrosamines) seems to increase directly with increased linoleic acid intake from vegetable oils.

Ok, moving on for now. I really wanted to find studies measuring the effect of eating cured (nitrate/ite treated) meat compared to uncured meats on cancer incidence with no additional variables. So far, no luck in human or animal studies. Still, I found some interesting studies worth looking at:

  1. In a composite of several studies, groups of 100 total rats were injected with azoxymethane (a chemical that causes colon cancer) and fed either beef, chicken, or bacon for 100 days (this procedure was repeated using higher and lower fat diets). The researchers then looked for aberrant crypt foci (ACF) throughout the rat's colons. ACF are used as crude markers of tumor promotion. The bacon diet not only didn't appear worse, but in certain cases actually seemed to result in better ACF measurements.

  2. Another study fed 9 mice diets either composed of 18% hot dogs or not for 7 days. At the end of this period there was no difference in 7-methyldeoxyguanosine levels in the two groups. 7-MedG isn't itself a significant promoter of cancer, but is measured because it can be a crude marker for the formation of other oncogenic DNA adducts. Weak study, but interesting.

  3. In two related studies, actual humans (not rodents!) were, in the first study, fed either fresh red meat or a vegetarian diet. In the second study subjects were fed either processed meat or a vegetarian diet. The trials lasted 14 days. Indicators of colon cancer risk were examined, including intestinal cell DNA breaks,and indicators of oxidized pyrimidines and altered purines. Comparing the fresh red meat and processed meat diet was suggestive of a slightly worse effect of the processed meat, although interestingly enough the vegetarian diet group produced significantly worse values on all things measured compared to both meat groups.

So based on all of this, let me expand and reiterate my original opinion a bit (and finish this increasingly long answer): I think that some gently cooked meat cured with nitrates/nitrites (with all other things being equal) in a diet rich in plants and low in omega-6 rich seed oils is unlikely to be a significant contributer to cancer risk.

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 02, 2012
at 02:23 PM

But, I don't think liver cancer isn't necessarily the most likely nitrosamine-induced cancer. Stomach cancer, for example, has been associated with nitrosamines, including from cured meat and, in some studies, from leafy green vegetables....

A2c38be4c54c91a15071f82f14cac0b3

(12682)

on August 02, 2012
at 09:30 AM

Also, this is yet one more time you've made me research and reevaluate my opinion on something, Matt. +1 and thanks for that.

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 02, 2012
at 03:25 PM

Jay, epidemiology only gets us so far. I saw reference to a study that found a statistically insignificant link between bacon and cancer, but also found that the same level of correlation existed between chicken breast and cancer.

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 02, 2012
at 02:24 PM

But, I don't think liver cancer is necessarily the most likely nitrosamine-induced cancer. Stomach cancer, for example, has been associated with nitrosamines, including from cured meat and, in some studies, from leafy green vegetables....

32f5749fa6cf7adbeb0b0b031ba82b46

(41757)

on August 02, 2012
at 03:23 PM

Thanks for the thoughtful reply, Mscott. It does appear that the dose humans get from cured meats is well-below what induces cancer in lab animals. Couple this with the idea that the nature of the nitrosamines are different - added vs formed in the food, pure NDMA vs whatever mixture forms during cooking, etc... Heck, I would also assume that differences in digestive system pH and transit time would also affect how carcinogenic these compounds are.

77877f762c40637911396daa19b53094

(78467)

on September 30, 2012
at 03:45 AM

And what are the references to the two studies you mention Matt?

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