Should you be worried about nitrates in processed meat? That’s a question I get asked often.

Last fall, I shared an informal Instagram story where I was eating a meat stick, and boy, was I not expecting that to be controversial.

My messages blew up with concerns about nitrates and processed meat. 

“I heard nitrates are bad for you!”

“I can’t believe you’re eating processed meat. Are you concerned about getting cancer?”

“Even though that meat stick is uncured, it still contains nitrates. With all you write about real food, I’m surprised you’re eating that!”

Let’s level the playing field here. I’ll start with the concerns over nitrates in processed meat.

Should you be worried about nitrates in processed meat?

Humans have been preserving meat for thousands of years with natural curing methods. Often those curing methods include using salt and herbs/spices and some of those herbs/spices naturally contain nitrates. The meat sticks I was eating fall into that category.

Nitrates are compounds that I believe have been wrongfully demonized, and I say that as someone who, at one time, tried to strictly avoid added nitrates in my diet. Like so many people, I also believed that they are harmful to human health. But the idea that nitrates are net harmful has been questioned in recent decades.

In a paper entitled “Inorganic nitrite and nitrate: evidence to support consideration as dietary nutrients”, the authors go into a ton of detail on the role of these compounds on endothelial health and nitric oxide production. Translation: they’re good for your heart and blood vessels. (More on this later…)

If you’ve ever heard of people eating extra beets or taking beet extracts to drop their blood pressure, the active compound primarily responsible for these effects is nitrate. Within the body, nitrate is converted to nitrite, which can then be used to make nitric oxide, resulting in vasodilation and lower blood pressure.

That paper also makes the case that perhaps nitrates are essential dietary nutrients rather than harmful food additives, mostly due to how they regulate nitric oxide levels in our bodies.

Which foods contain nitrates?

The majority of dietary nitrates we consume are NOT from processed meat. In fact, only 5% come from processed meat. 

More than 85% of dietary nitrates come from vegetables.

Now, when I mention this, the immediate rebuttal that I get from people is that the reason nitrates in processed meats are harmful is from nitrosamines, which you won’t get from vegetables.

What are nitrosamines, you ask? Nitrosamines are a compound formed primarily when nitrite + high heat + proteins interact. This compound has indeed been linked to certain cancers.

While nitrosamines are something we want to avoid, modern curing practices in the U.S. and most developed countries require ascorbate (vitamin C) to be added during curing to prevent nitrosamine formation. This is well-documented in the literature and mandated in USDA regulations for most cured meats since the 1970s.

Another concern is that nitrosamines could form within the body. However, if you consume vitamin C and other antioxidants (like polyphenols from fresh produce) at the same time as nitrate-containing cured meat, you can inhibit nitrosamine formation in your stomach. So, having a meatstick along with something like an orange would have you covered.

Both the International Agency for Research on Cancer (IARC) and the European Food Safety Authority (EFSA) have stated that there is inadequate evidence in humans for the carcinogenicity of nitrate in food.

Could nitrates be good for you?

I know this sounds absolutely crazy, but let me explain. Dietary nitrates can be beneficial because they can be converted in the body into nitric oxide, a signaling molecule that helps relax and widen blood vessels, supporting healthy blood flow and blood pressure. In this pathway, bacteria in the mouth first convert nitrate into nitrite, which can then be further converted into nitric oxide, particularly under low-oxygen or acidic conditions. That may help explain why higher intake of nitrate has been linked to lower blood pressure and better cardiovascular function. If you don’t believe me, keep reading.

The data on nitrate is so compelling, that there are trials where they supplement with nitrate to observe how it impacts blood pressure and vascular function. A 2025 systematic review and dose-response meta-analysis, which pooled data from 75 randomized controlled trials involving 1,823 participants, found that dietary nitrate supplementation produces dose-dependent reductions in blood pressure and improvements in vascular health. Specifically, for each millimole increase in nitrate intake, systolic blood pressure decreased across acute, short-term, and medium-term periods (up to −0.48 mmHg per mmol in the medium term), and diastolic blood pressure also declined. Beyond blood pressure, the analysis demonstrated linear dose-response improvements in key vascular health biomarkers, including reduced arterial stiffness, improved endothelial function, and decreased augmentation index. These benefits were accompanied by corresponding dose-dependent increases in plasma nitrate and nitrite levels, supporting the mechanistic role of the nitrate-nitrite-nitric oxide pathway in mediating these cardiovascular effects.

Dietary nitrate also supports healthier blood pressure, but keep in mind it’s the dose that matters — and, as I pointed out earlier, vegetables are the richest source of nitrate. In a 2026 UK National Diet and Nutrition Survey analysis of 3,338 adults, the researchers built a database of nitrate and nitrite concentrations in vegetables, drinking water, processed meats, and composite dishes, then grouped people into quartiles of intake from each source. Vegetable nitrate intake ranged roughly from 3–65 mg/day in the lowest group to >131 mg/day in the highest group, while nitrate from processed meats was tiny by comparison: only 0.1–0.8 mg/day in the lowest group and 1.8–3 mg/day in the highest group. Vegetable nitrate was associated with lower blood pressure and better CVD markers, whereas processed-meat nitrate was not. This is no surprise given the amount of nitrate from processed meat is so low that it’s unlikely to have any effect on blood pressure.

That last point is an important one. The lack of benefit is, in part, due to the nitrate levels in processed meat being so low to begin with. Ironic, isn’t it?! It’s also important to note that you can’t separate out the overall dietary pattern from the conversation. The so-called “healthy user bias” is a big factor in observational and epidemiological studies looking at diet. In short, the people who eat more vegetables typically make a number of other health-supporting choices, like not smoking, not drinking alcohol, not consuming excessive amounts of sugar, and engaging in physical activity. On the flip side, people who ignore public health advice to limit processed meats are also the ones consuming that hot dog on an ultraprocessed, white flour bun, with a side of fries, and washed down with a soda or beer.

There have been some other areas that research has explored with regards to health effects of nitrates, primarily from animal models. Briefly, some mouse studies have tested out nitrate supplementation to see whether it has an effect on metabolic or bone health.

A 2017 study published in Diabetologia demonstrated that feeding mice a specially formulated low-nitrite/nitrate diet (LND) — with undetectable levels of these compounds but otherwise nutritionally matched to a regular diet — induced features of metabolic syndrome over time. Short-term (3 months) exposure to a low nitrate diet caused visceral adiposity, dyslipidemia, and glucose intolerance, while longer periods (18–22 months) led to increased body weight, hypertension, insulin resistance, endothelial dysfunction, and premature cardiovascular death (primarily from conditions like acute myocardial infarction). These adverse effects were reversed by supplementing with sodium nitrate and were linked to mechanisms including downregulation of endothelial nitric oxide synthase (eNOS), adiponectin insufficiency, and gut microbiota dysbiosis, providing the first evidence that chronic dietary nitrite/nitrate deficiency plays a causal role in metabolic syndrome and its vascular complications in mice.

There’s even some emerging research from studies in mice suggesting that nitrates may naturally protect against osteoporosis. In this study, nitrate deficiency worsened osteoporosis in osteopenic mice, and supplementation with nitrate stimulated bone-building activity by increasing a marker called PINP, helping special stem cells in the bone marrow (BMSCs) grow better and turn into bone-forming cells more effectively. Nitrate supplementation also activated key signaling pathways (like EGFR/AKT/ERK) that support bone formation.

I share these studies because when I first came across research on potential benefits of nitrate, I found it hard to believe! Certainly, any animal studies don’t automatically correlate to humans, but the data we have in humans is reassuring nonetheless.

Takeaway on nitrate from processed meat, vegetables, and other sources

All together, I’m not concerned with the tiny amount of nitrates from cured meat, whether from celery powder or from nitrates/nitrites added to cured meat. I’m getting far more nitrate from a salad than a serving of cured meat. Romaine lettuce has 2,198 mg/kg of nitrate whereas bacon has only 72 mg/kg — meaning lettuce is over 30x more concentrated in nitrate. And this isn’t a bad thing! It may be part of the reason that vegetables are good for us. You can look up nitrate concentrations in different foods here if you’re curious.

I’m including a graphic from one of the research papers cited in this article to give you some extra context on the benefit:risk equation with nitrates.

Image source: Bryan, Nathan S, and John L Ivy. “Inorganic nitrite and nitrate: evidence to support consideration as dietary nutrients.” Nutrition research. vol. 35,8 (2015): 643-54.

Beyond nitrates, isn’t processed meat bad for you?

I know you probably have a bunch of other questions for me on processed meat in general and I’ll be the first to acknowledge that it’s a gigantic rabbit hole. I touch on some of the issues of how this has been studied in Real Food for Fertility (see chapter 5). As I mentioned earlier, one key point is that people who eat a lot of processed meat usually have poor overall diet quality and health habits (alcohol, smoking, inactivity, etc.), which skews much of the epidemiological evidence. These “confounding variables” make it difficult to separate out health effects of single foods or habits.

Without getting too into the weeds on the topic of processed meat… while I’m not concerned about nitrates, I’ll be the first to say not all cured meat is healthy. Much of what’s on the market isn’t made with the best quality meat and there are some ingredients I personally try to avoid when possible, like BHA (butylated hydroxyanisole). This is a preservative that some research has linked to cancer (it’s classified by the International Agency for Research on Cancer — or IARC — as Group 2B: “possibly carcinogenic to humans”).

So, when possible, still consider the quality of processed meat products and the overall ingredient list, even if nitrates/nitrites aren’t specifically an ingredient to worry about. I’m all for some dry-aged, traditionally made Italian salami, but I’ll pass on the cheap bologne, thanks.

I heard processed meat is carcinogenic? What are your thoughts on that?

In 2015, the International Agency for Research on Cancer (IARC), which is part of the World Health Organization, classified processed meat as a Group 1 carcinogen, meaning there is sufficient evidence that it causes cancer in humans, specifically colorectal cancer. 

This classification was based on a review of epidemiological studies by a working group of researchers. They overall found a positive association between processed meat consumption and colorectal cancer risk. For example, one study cited in the report indicated an 18% increased risk for every 50 grams of processed meat consumed daily. The 18% risk increase claim relied heavily on a single 2011 meta-analysis focused on fried sausage and processed pork products, yet was generalized to all processed meats.

It’s crucial to note that this classification reflects the certainty of the evidence, not the magnitude of risk. Since the 2015 decision, several studies, reviews, and expert critiques have challenged the strength of the evidence, arguing that the associations are weak, potentially confounded, and do not prove causation. These criticisms often highlight methodological limitations in the original studies and question whether the data justifies broad public health recommendations to reduce processed meat intake.

Critics note that the relative risks reported (around 1.17-1.18) are small and could be explained by biases, residual confounding (e.g., from smoking, low physical activity, or poor diet overall), or measurement errors in dietary reporting. Relative risks at this level are often considered too low to establish causality reliably.

For example, a 2018 report emphasized that while hazard identification (IARC’s focus) labels processed meat as carcinogenic, actual risk depends on exposure levels, and small daily amounts may pose minimal absolute risk (e.g., increasing lifetime colorectal cancer risk from 5% to 6%).

Multiple sources stress that IARC identifies hazards (potential to cause harm) but not risks (likelihood based on exposure). This has led to media exaggeration, equating processed meat with smoking, despite vastly different risk levels—smoking causes far more cancers.

A 2015 analysis noted that even at high intakes (up to 140g, or about 5 oz per day), colorectal cancer risk increases are modest and plateau.

A very thorough 2021 review concluded that the evidence for processed meat’s carcinogenicity is not methodologically strong, as many studies fail to adequately control for the aforementioned issues, and the same limitations apply to red meat data. This paper concludes with the following:

“Thus, the recommendation to reduce the consumption of processed meat and meat products to protect against cancer in the general population does not seem to be convincingly substantiated on the evidence that is methodologically strong. Clearly, there is still a lack of randomized trials evaluating the effect of lowering processed meat intake, and while such trials may be infeasible, cohort studies do not lend strong support for an association.”

Altogether, my opinion is that overall diet quality and the quality of processed meat consumed probably has more of a bearing on cancer risk than we think (no studies to date assess this risk relative to the ingredients and quality of the processed meat). For what it’s worth, I’m also of the opinion that most of the meat we consume should be unprocessed meat.

A note about nitrate-contaminated drinking water

Circling back to nitrates for a moment… Like most things, there’s a level at which nitrates can be excessive and have health risks, and this can be an issue with contaminated municipal water supplies due to fertilizer run off from farms. That can introduce a level of nitrates that’s far beyond what you get from any dietary source. Just want to make sure I call that out! A large Danish cohort study (n = 54,610) found no association between food-sourced nitrate/nitrite and colorectal cancer (regardless of whether the nitrates were from plant or animal foods), though higher tap water nitrate was linked to increased distal colon cancer risk.

Summary: Should you worry about nitrates in processed meat?

Hopefully this helps give you some clarity (and reassurance) on dietary nitrates, and also some considerations with the other ingredients of concern in processed meat. If I can sum up my thoughts here:

• Nitrates are not inherently harmful and actually have cardiovascular benefits. In the body, nitrate can convert to nitrite and then nitric oxide, a compound that supports blood vessel relaxation, healthy blood flow, and blood pressure regulation.
• Most dietary nitrate comes from vegetables, not processed meat. Vegetables account for the vast majority of nitrate intake, while processed meats contribute only a small fraction. Foods like lettuce, beets, arugula, and other greens can contain far more nitrate than bacon, salami, or meat sticks.
• Nitrosamines are the bigger concern, not nitrate itself. Nitrosamines can form when nitrite, protein, and high heat interact, but modern curing practices often use vitamin C/ascorbate to reduce nitrosamine formation. Also consuming produce rich in vitamin C and polyphenols when you eat processed meat can inhibit nitrosamine formation in the stomach.
• Most meat intake should still come from unprocessed meat, and quality matters with processed meat. Traditionally made cured meats can fit into a real food diet, but they should not replace fresh, high-quality meat, seafood, eggs, and other nutrient-dense foods. I don’t encourage you to eat processed meats that contain lower-quality ingredients or preservatives, such as BHA.
• Nitrate-contaminated drinking water is a separate issue. High nitrate levels in water from agricultural runoff can pose health concerns and should not be lumped together with normal nitrate intake from foods.

What’s your opinion on nitrates in processed meat? Tell me in the comments below.

This article was inspired by an email newsletter I sent on the topic many months ago. Since so many readers wanted the information to be sharable, I decided to expand upon my thoughts here in this article. My newsletter list is always the first to hear my thoughts on controversial topics in nutrition, so make sure you get on the list.

Until next time,
Lily

PS – I personally find meat sticks a convenient shelf-stable, high-protein snack to have on hand, especially while traveling. These are the ones I like most. They’re made with grass-fed beef, seasoned with organic herbs/spices, and don’t have any icky ingredients. They taste good and the kids like them too. I’m mentioning them here to cut down on the number of emails/messages asking me for “good” meat sticks!

 

References

• Bryan, Nathan S, and John L Ivy. “Inorganic nitrite and nitrate: evidence to support consideration as dietary nutrients.” Nutrition research (New York, N.Y.) vol. 35,8 (2015): 643-54.
• Norouzzadeh, Mostafa et al. “Plasma nitrate, dietary nitrate, blood pressure, and vascular health biomarkers: a GRADE-Assessed systematic review and dose-response meta-analysis of randomized controlled trials.” Nutrition journal vol. 24,1 47. 24 Mar. 2025
• Alzahrani, Hayat S., et al. “Dietary sources of nitrate and nitrite and associations with blood pressure and other cardiovascular disease risk factors in a representative UK population.” The Journal of Nutrition (2025).
• Kina-Tanada, Mika et al. “Long-term dietary nitrite and nitrate deficiency causes the metabolic syndrome, endothelial dysfunction and cardiovascular death in mice.” Diabetologia vol. 60,6 (2017): 1138-1151.
• Li, Xiaoyu et al. “Salivary nitrate prevents osteoporosis via regulating bone marrow mesenchymal stem cells proliferation and differentiation.” Journal of orthopaedic translation vol. 45 188-196. 25 Mar. 2024
• Bouvard, Véronique, et al. “Carcinogenicity of Consumption of Red and Processed Meat.” The Lancet Oncology, vol. 16, no. 16, 2015, pp. 1599-1600.
• International Agency for Research on Cancer. Red Meat and Processed Meat. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, vol. 114. Lyon: IARC, 2018.
• Chan, Doris S. M., et al. “Red and Processed Meat and Colorectal Cancer Incidence: Meta-Analysis of Prospective Studies.” PLoS One, vol. 6, no. 6, 2011, e20456.
• Händel, Mina Nicole, et al. “Processed meat consumption and the risk of cancer: a critical evaluation of the constraints of current evidence from epidemiological studies.” Nutrients 13.10 (2021): 3601.
• Erichsen, Dorit W et al. “Source-specific nitrate and nitrite intake and association with colorectal cancer in the Danish Diet, Cancer and Health Cohort.” Environment international vol. 202 (2025): 109658.