Michael Hunter, MD on Medika Life

Should We Follow the French When It Comes to Nitrites?

FIRST, A CONFESSION: I LOVE BACON. I don’t love that I eat other animals or that I may be increasing my cancer risk. So I eat it in moderation, preferably nitrate-free. (Don’t get me going on how not everyone has access to such products or can afford them.)

This week, France announced that it intends to cut the use of nitrites in food. The disturbing context: The French National Health Agency confirmed that nitrite raises our cancer risk. Still, the agency did not institute a full ban on nitrite use in products such as sausages and ham.

Today, let’s look briefly at the review and recommendations that led the French government to act on the addition of nitrites to food. First, though, a bit about nitrites.

What are nitrates and nitrites?

We begin with some chemistry: Nitrates (NO3) have one nitrogen atom and three oxygen atoms. Nitrites (NO2) consist of one nitrogen atom and two oxygen atoms.

Both of these substances occur naturally within us. Some vegetables have nitrates and nitrites, too. And as you now know, manufacturers commonly add them to processed foods such as bacon. The additives allow our food to last longer.

Nitrates are relatively inert; they are stable and unlikely to cause harm. However, mouth bacteria or body enzymes can convert nitrates to potentially harmful nitrites.

More specifically, nitrites can turn into:

  • Nitric oxide, a beneficial substance
  • Nitrosamines, a harmful substance
Photo by Jonathan Pielmayer on Unsplash

Do you know why your cured meat is pink or red? Yep, it’s the nitrites added to the food. In meat, nitrites become nitric oxide. The nitric oxide reacts with meat proteins, resulting in a change in color and food preservation.

In summary, nitrates and nitrites are compounds composed of oxygen and nitrogen atoms. Nitrates can become nitrites, forming either “good” nitric oxide or “bad” nitrosamines.

Where do we find nitrates?

While many processed foods contain nitrates, healthy foods such as vegetables contain them, too. Our drinking water has some, and our bodies can produce nitrates.

We can transform processed meat via curing, salting, fermentation, smoking, or other processes to enhance preservation or improve flavor.

Did you know that our bodies make nitrates and that we then secrete the substance into our saliva?

Nitrites, nitrates, and the French authorities

Earlier this year, the French parliament introduced a bill to reduce nitrite use for cured meats gradually. They based their move on a review by the health agency ANSES.

This comprehensive review from Anses confirmed the report of the World Health Organization that nitrates and nitrites ingested via processed meats are associated with colorectal cancer.

Moreover, ANSES suspects a link between nitrates and nitrites to breast, kidney, ovarian, and pancreas cancer.

The government did not propose a ban on nitrates, offering that 99 percent of the French population did not exceed the allowable daily doses for all exposures to nitrites or nitrates.

If you want to follow the lead of our French friends, consider:

“Cutting your exposure to nitrites and nitrates by “limiting consumption of charcuterie* to 150 grams [about 5.3 ounces] per week. Consume a varied and balanced diet, with at least five portions of fruit and vegetables per day.”

*Charcuterie is French for a cooking branch devoted to prepared meat products, such as sausage, ham, bacon, and terrines.

My take — Nitrites and nitrates

I know, I know: Association is not causality. Still, ANSES found that the higher the exposure to nitrites and nitrates, the greater the risk of colorectal cancer. For me, it means being careful to limit processed foods. When I do eat my tasty bacon, I will choose nitrate-free.

And the French processed food industry counters that lower use of nitrites will reduce the expiration date of ham while increasing the risk of salmonella in cured sausages.

What is your take on nitrates? Thank you for joining me today


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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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