Dr. Lisa Barker

Most health conscious people know that nitrates and nitrites are not healthy for us and can potentially cause cancer.  There are some nuances to this and so the blanket statement that they are harmful, is not completely true.

What are Nitrates and Nitrites?

A nitrate is a nitrogen atom plus 3 oxygen atoms and a nitrite is the same except it only has two oxygen atoms.  Nitrates and nitrites can occur naturally in some vegetables, such as beets, but they are also added to deli meats as a preservative, flavor, and color enhancer.  They are also produced by our body and circulate between our saliva and digestive tract. Nitrates are converted into nitrites when ingested by our saliva and digested .  Nitrites can either convert into nitric oxide (NO) which is healthy or nitrosamines which are carcinogens.  Nitric oxide is antimicrobial in the digestive tract and is a signaling molecule that dilates blood vessels. Nitrosamines are converted from nitrites when they are heated to a very high temperature in the presence of amino acids or when reacting to stomach acid.  The key here is high heat.  We typically heat meat at high temps compared to vegetables.  Just think how harmful cured hot dogs are, when heated to high temperatures on the grill.  Also, processed meat companies are required to add Vitamin C which interferes with nitrosamine production (4). Most vegetables and fruits naturally contain Vitamin C (6).

Nitrate Food Sources

Sodium nitrate cannot be added to food products that are labeled organic.  Instead organic foods and products choosing to be “naturally uncured” use sea salt, celery juice, or celery salt instead. Vegetables that are high in nitrates can mix with your saliva and can convert to nitric acid or NO. Nitric oxide remember is good for you, and I’ll explain why in a minute. It is therefore, a good idea to incorporate nitrate laden vegetables into your diet.  Beets, celery, arugula, spinach, and iceberg lettuce are all very high in nitrates (5). Fruits are less nitrate dense, with strawberries trumping the list (6).

Benefits of Nitric Oxide (NO)

Cardiovascular Health

Nitric oxide dilates blood vessels and increases blood flow thus improving cardiac health.  In one study, dietary flavonoids and nitrates were shown to lower blood pressure depending on the availability of NO, which is dependent on the conversion of nitrate to nitrite via salivary enzymes (3).

Male Sexual Performance

For men, NO can increase testosterone and enhance erectile quality.  NO is a vasodilator, so increased blood flow to the penis.  In fact, the key ingredient in Viagra and Cialis is NO (5)

Exercise Performance

Athletes are using vegetable nitrate supplements for increased endurance and exercise performance.  Beetroot juice and potassium nitrate are popular supplements.  One study showed that a high NO diet decreased oxygen used during moderate intensity cycling, increased muscle work during fatigability tests, and improved agility in repeated sprinting tests (2).

Anti-platelet

Nitrates converted to NO were shown to reduce platelet reactivity but only in males, according to one study.  This is promising for more future studies as a concomitant to anti-platelet drug therapy (1).

My Advice Regarding Nitrates

Bacon is best cooked in the microwave to reduce nitrosamine production or cook it on a lower temperature for a longer period of time. Children have a very hard time processing excess amount of nitrates, so limit their exposure to hotdogs and processed meats (4).  My recommendation for any age, is to buy cold cuts sparingly and when you do, buy them nitrate free or uncured.  Also, when eating out, don’t order meals with cured meats, like a BLT for instance, unless the menu specifically says uncured bacon.  As a precaution, NO can give some people migraines.

1. Velmurugan S, Kapil V, Ghosh SM, Davies S, McKnight A, Aboud Z, Khambata RS, Webb AJ, Poole A, Ahluwalia A. Antiplatelet effects of dietary nitrate in healthy volunteers: involvement of cGMO and influence of sex. Free Radic Biol Med. 2013 Dec;65:1521-32.
2. Porcelli S, Pugliese L, Rejec E, Pavei G, Bonato M, Montorsi M, La Torre A, Rasica L, Marzorati M. Effects of a Short-Term High-Nitrate Diet on Exercise Performance. Nurtrients. 2016 Aug 31;8(9)
3. Lovegrove JA, Stainer A, Hobbs DA. Role of flavonoids and nitrates in cardiovascular health. Proc Nutr Soc. 2017 Jan 19:1-13
4. Gunnars, Chris. Are Nitrates and Nitrites in Foods Harmful? 2017. Healthline 4 June 2017. <https://www.healthline.com/nutrition/arenitratesandnitritesinfoodsharmful?.html.>
5. Kuoppala Ali. 5 Food High in Nitrates to Blast Your Nitric Oxide Levels Through the Roof. 2014. Anabolic Men. <https//www.anabolicmen.com/amp/>
6. Dubois, Sirah.  Fruits and Vegetables That Are High in Nitrates. 2017. Livestrong 3 October 2017. <https://www.livestrong.com/article/5413.