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Q: I am confused about a few tips on nutrition. Some say some foods are good. While others say they are bad. Who should we believe?
Krishna: :)
Recently I read a research paper. It tells us a lot about why this thing happens.
Despite our understanding of nutrition expanding remarkably in recent times, few aspects of our diet continue to confuse and divide the experts like nitrate.
For a long time nitrate has been viewed warily, with previous research showing it could potentially be linked to causing cancer.
However, subsequent research has revealed dietary nitrate also has various cardiovascular health benefits, which could help reduce the risk of related conditions such as heart disease, dementia and diabetes.
Hmmm! Now who do you believe? Take nitrates or not? How can one dietary compound have such contrasting potential risks and benefits?
So some other scientists tried to find the answers and made a review of nitrate research and they say the key may lie in where nitrate comes from.
We get nitrate from three major dietary sources: meat, water and vegetables.
Nitrate's reputation as a health threat stems from 1970, when two studies showed it can form N-nitrosamines, which are highly carcinogenic in laboratory animals.
Nitrosamines (or more formally N-Nitrosamines) are chemical compounds that can form in food as a result of food preparation and processing. They have been found in several types of foodstuffs such as cured meat products, processed fish, cocoa, beer and other alcoholic beverages (1).
Nitrosamines are formed by reaction of secondary or tertiary amines with a nitrosating agent. In foods, the nitrosating agent is usually nitrous anhydride, formed from nitrite in acidic, aqueous solution. Food constituents and the physical make-up of the food can affect nitrosamine formation (1).
Ascorbic acid and sulfur dioxide are used to inhibit nitrosamine formation in foods. Nitrosodimethylamine has been shown to be formed in certain foods as a result of the direct-fire drying process. In this case, oxides of nitrogen in the drying air nitrosate amines in the food being dried. The volatile nitrosamine which occurs most commonly in food is nitrosodimethylamine, and nitrosopyrrolidine occurs to a lesser extent (1).
So nitrate is not good if it comes from nonvegetarian sources. Cooking and processing of food makes it take a dangerous form.
However, no human studies have confirmed its potential dangers, and clinical and observational studies support nitrate preventing cardiovascular disease, if it's sourced from vegetables.
Despite recent research indicating the source of nitrate may affect its health benefits and risks, current dietary guidelines relating to nitrate have been in place since the 1970s and don't differentiate between nitrate from meat, vegetables and water.
Unlike meat and water-derived nitrate, nitrate-rich vegetables contain high levels of vitamin C and/or polyphenols that may inhibit formation of those harmful N-nitrosamines associated with cancer.
The public are unlikely to listen to messages to increase intake of nitrate-rich vegetables, if they are concerned about a link between nitrate intake and cancer. And if this difference between non-veg and veg nitrates is not explained properly, people will get confused and refuse to eat all nitrate containing food.
So current evidence suggests people should aim to get their nitrate from vegetables—but there is no need to go overboard. Dark green, leafy vegetables and beetroot are good sources, and research shows one cup of raw, or half a cup cooked per day is enough to have the benefits on cardiovascular health (2).
Now do you understand why this confusion occurs? Those researchers who are dealing with meat say nitrate can cause cancer. Those who deal with processed foods and cooked meat say it is harmful.
While those researchers who deal with vegetarian food say it is beneficial.
Journalists report these things without clearly mentioning what is what as they themselves cannot understand this or don't have full knowledge.
Only experts/researchers who do meta analyses can differentiate between these different types and clear the matter.
So listen to only experts.
Footnotes:
1. https://pubmed.ncbi.nlm.nih.gov/6831466/#:~:text=Nitrosamines%20are....
2. Catherine P. Bondonno et al, Nitrate: The Dr. Jekyll and Mr. Hyde of human health?, Trends in Food Science & Technology (2023). DOI: 10.1016/j.tifs.2023.03.014
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Nitrate in drinking water linked to increased dementia risk while nitrate from vegetables is linked to a lower risk Higher nitrate intake from drinking water, animal foods, and processed meats is associated with increased dementia risk, even at levels below current regulatory limits, while nitrate from vegetables is linked to a lower risk. The differing effects may relate to the presence of antioxidants in vegetables, which promote beneficial nitric oxide formation and inhibit harmful N-nitrosamines. Nitrate in drinking water linked to increased dementia risk while nitrate from vegetables is linked to a lower risk New research from Edith Cowan University (ECU) and the Danish Cancer Research Institute (DCRI) investigated the association between the intake of nitrate and nitrite from a wide range of different sources, and the associated risk of dementia. Dementia is a complex disease shaped by both genetics and lifestyle, and Post-Doctoral Research Fellow at ECU's Nutrition & Health Innovation Research Institute (NHIRI) and the DCRI, Dr. Nicola Bondonno said dietary factors could also be important. The research, which investigated the association between source-specific nitrate and nitrite intake and incident and early-onset dementia, followed more than 54,000 Danish adults for up to 27 years and found that the source of nitrate was of critical importance in a diet. The study is published in the journal Alzheimer's & Dementia. The researchers found that people who ate more nitrate from vegetables had a lower risk of developing dementia, while those who consumed more nitrate and nitrite from animal foods, processed meats, and drinking water, had a higher risk of dementia. ECU Associate Professor Catherine Bondonno said that nitrate intake from vegetables has been linked with a lower risk of dementia, which is thought to be a result of the conversion of nitrate to nitric oxide in the body. "When we eat nitrate-rich vegetables, we are also eating vitamins and antioxidants which are thought to help nitrate form the beneficial compound, nitric oxide, while blocking it from forming N-nitrosamines which are carcinogenic and potentially damaging to the brain. "Unlike vegetables, animal-based foods don't contain these antioxidants. In addition, meat also contains compounds such as heme iron which may actually increase the formation of N-nitrosamines. We think this is why nitrate from different sources has opposite effects on brain health, but we need laboratory studies to confirm exactly what's happening," she said. This is the first time that nitrate from drinking water has been linked to higher risks of dementia. The study found that participants exposed to drinking-water nitrate at levels below the current regulatory limits had a higher rate of dementia, however, Dr. Bondonno stressed that this was only one study, and more research was required. "Water doesn't contain antioxidants that can block formation of N-nitrosamines. Without these protective compounds, nitrate in drinking water may form N-nitrosamines in the body," she said. In Denmark and the EU, the limit for nitrate in groundwater and drinking water is set at 50 mg/L, but the researchers observed a higher risk for drinking water containing as low as 5 mg of nitrate per liter. "Importantly, our results do not mean that people should stop drinking water. The increase in risk at an individual level is very small, and drinking water is much better for your health than sugary drinks like juices and soft drinks. However, our findings do suggest that regulatory agencies should re-examine current limits and better understand how long-term, low-level exposure affects brain health." She simultaneously emphasizes that this is an observational study, which cannot establish that nitrate directly causes dementia. The results must therefore be confirmed in other studies, and it cannot be ruled out that other factors in participants' diets or lifestyles contribute to the association. Dr. Bondonno said the take-home results from the study is fairly simple: people who consume more nitrate from vegetables, equating to around one cup a day of baby spinach, have a lower risk of dementia. On the other hand, people who consumed more nitrate from animal-based foods, particularly red and processed meat, had a higher risk. "Eating more vegetables and less red meat and processed meat is a sensible approach based on our findings and decades of other research on diet and health," she added.
Catherine P. Bondonno et al, Source‐specific nitrate intake and incident dementia in the Danish Diet, Cancer and Health Study, Alzheimer's & Dementia (2025). DOI: 10.1002/alz.70995
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