Risk Assessment of Nitrite and Nitrate Intake from Processed Meat Products: Results from the Hellenic National Nutrition and Health Survey (HNNHS)

Assessment of dietary exposure to food additives used in Polish processed meat products

Dietary exposure assessments have been performed for nitrites, phosphates, erythorbic acid, and sodium erythorbate in processed meat in Poland. The exposure has been estimated based on the maximum level of use of additives contained in Regulation - tier 2 and the concentration of additives in processed meat - tier 3, additionally for nitrites. Daily intake was estimated using 24-h recall, repeated three times. Exposure analyses were correlated with the frequency of occurrence of food additives based on label analysis (tiers 2a and 3a). The mean nitrite intake from processed meat at tier 2 was 0.1 mg/kg bw (143% ADI), 0.08 mg/kg bw (118% - ADI) at tier 2a, 0.03 mg/kg bw (43% - ADI) at tier 3, and 0.026 mg/kg bw (37% - ADI) at tier 3a. The mean intakes of phosphate and erythorbic acid/sodium erythorbate from processed meat were 3.26 and 0.54 mg/kg bw (8.2% and 9% - ADI), respectively at tier 2. None of the respondents exceeded the ADIs for phosphates or erythorbic acid/sodium erythorbate. In contrast, nitrite consumption is of great concern because of significant ADI exceedances, particularly among young children.

Determination of nitrate and nitrite levels in enteral nutrition formula marketed in Turkey: A risk assessment study

In this study, the nitrite and nitrate levels of 37 enteral nutrition formulas of three different international brands marketed in Turkey were evaluated using high-performance liquid chromatography with diode-array detection (HPLC-DAD). Also, risk assessment of non-carcinogenic was calculated by models including hazard quotient (HQ) and hazard index (HI) in the deterministic model. Enteral nutrition formula consumption amounts obtained from individuals between the ages of 6-36 volunteers voluntarily participated in the study, and health risk assessments were calculated. The range of concentration of nitrate levels in enteral formulas of brands (B1, B2, and B3) was determined as 11.08 ± 2.88 (2.90-15.79), 11.64 ± 3.39 (2.92-22.93), and 10.66 ± 3.46 (4.92-15.37) mg/kg, respectively. The range of concentration of nitrite levels in enteral formulas of brands (B1, B2, and B3) was determined as 4.18 ± 1.10 (1.86-5.82), 3.70 ± 1.25 (1.29-5.26), and 3.38 ± 1.67 (2.00-5.29) mg/kg, respectively. The mean nitrate and nitrite levels of exposure from consumption of enteral nutrition formulas were determined as 0.14 and 0.11, 0.06 and 0.07 mg/kg bw/day for females and males, respectively. Nitrate and nitrite exposure levels calculated in the study did not exceed the ADI threshold values given by JECFA. The average HQ value calculated for the exposure of nitrate to male and female individuals was less than 1. Still, the P95 values calculated for nitrate were greater than 1.00 except for female and male individuals (24-36 ages). The HI value was found to be greater than 1.00 in all age groups of both genders. The presence of nitrites and nitrates in enteral nutrition formulas may lead to health problems in sensitive groups.

Nitrite and nitrate intake from processed meat is associated with elevated diastolic blood pressure (DBP)

BACKGROUND AND AIMS

Processed meat consumption has been linked to high blood pressure (BP), a key risk factor for cardiovascular disease (CVD), but gaps remain with regards to the ingredients which contribute to this association. This study, therefore, aimed to examine the association between nitrite and nitrate intake from processed meat with diastolic (DBP) and systolic (SBP) blood pressure, while accounting for sodium intake.

METHODS

Dietary nitrite and nitrate intake from processed meat, assessed as total nitrite equivalent, was estimated for 1774 adult, processed meat consumers (≥18 years, 55.1% females) who had enrolled in the Hellenic National Nutrition and Health Survey (HNNHS). To avoid selection and reverse causality bias, associations with measured DBP and SBP were considered instead of self-reported data of hypertension presence. Participants were divided by tertile of dietary nitrite intake and by level of dietary guideline adherence for sodium (<1500; 1500-2300; ≥2300). Multiple regression models were used to examine associations with SBP and DBP, including an interaction term of nitrite with dietary sodium intake, for potential synergy.

RESULTS

Overall, DBP increased by 3.05 mmHg (95% CI: 0, 6.06), per tertile increase in nitrite intake and 4.41 mmHg (95% CI: 0.17, 8.64) per level increase in sodium intake, when the interaction effect between nitrite and total sodium intakes was accounted for. By considering the significant synergistic effect of the two factors, DBP finally increased by 0.94 mgHg overall and 2.24 mgHg for subjects in the third tertile compared to those in the first. Also, a rise in total sodium intake of approximately 800 mg, above 1500 mg, caused a 2.30 mgHg increase in DBP. No significant correlations were found with SBP.

CONCLUSIONS

Higher nitrite and nitrate intake from processed meats contributed to the increase of DBP, but the interaction effect with total sodium intake levels should be accounted for to properly interpret the findings.