Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Feb 4;14(3):666.
doi: 10.3390/nu14030666.

Association between Dietary Nitrate, Nitrite Intake, and Site-Specific Cancer Risk: A Systematic Review and Meta-Analysis

Kassim Said Abasse  1 , Eno E Essien  2 , Muhammad Abbas  3 , Xiaojin Yu  2 , Weihua Xie  2 , Jinfang Sun  2 , Laboni Akter  4 , Andre Cote  1
Affiliations
Meta-Analysis

Association between Dietary Nitrate, Nitrite Intake, and Site-Specific Cancer Risk: A Systematic Review and Meta-Analysis

Kassim Said Abasse et al. Nutrients. .

Abstract

Background: People consume nitrates, nitrites, nitrosamines, and NOCs compounds primarily through processed food. Many studies have yielded inconclusive results regarding the association between cancer and dietary intakes of nitrates and nitrites. This study aimed to quantify these associations across the reported literature thus far.

Methods: We performed a systematic review following PRISMA and MOOSE guidelines. A literature search was performed using Web of Science, Embase, PubMed, the Cochrane library, and google scholar up to January 2020. STATA version 12.0 was used to conduct meta-regression and a two-stage meta-analysis.

Results: A total of 41 articles with 13 different cancer sites were used for analysis. Of these 13 cancer types/sites, meta-regression analysis showed that bladder and stomach cancer risk was greater, and that pancreatic cancer risk was lower with increasing nitrite intakes. Kidney and bladder cancer risk were both lower with increasing nitrate intakes. When comparing highest to lowest (reference) categories of intake, meta-analysis of studies showed that high nitrate intake was associated with an increased risk of thyroid cancer (OR = 1.40, 95% CI: 1.02, 1.77). When pooling all intake categories and comparing against the lowest (reference) category, higher nitrite intake was associated with an increased risk of glioma (OR = 1.12, 95% CI: 1.03, 1.22). No other associations between cancer risk and dietary intakes of nitrates or nitrites were observed.

Conclusion: This study showed varied associations between site-specific cancer risks and dietary intakes of nitrate and nitrite. Glioma, bladder, and stomach cancer risks were higher and pancreatic cancer risk was lower with higher nitrite intakes, and thyroid cancer risk was higher and kidney cancer risk lower with higher nitrate intakes. These data suggest type- and site-specific effects of cancer risk, including protective effects, from dietary intakes of nitrate and nitrite.

Keywords: cancer; dietary intake; humans; nitrate; nitrites; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Meta-regression: the association between the risk of logarithm ORs and median dosage of dietary nitrite and nitrate for selected site-specific cancers; (a). Pancreatic cancer Median Nitrite dosage, (b). Bladder cancer: Median = Nitrite dosage, (c). Stomach cancer: Median = Nitrite dosage, (d). Kidney cancer: Median = Nitrate dosage, (e). Bladder cancer: Median = Nitrate dosage.
Figure 3
Figure 3
ORs (95% CI) for thyroid cancer of the highest versus lowest category of dosage of dietary nitrate consumption for the following selected studies .
Figure 4
Figure 4
ORs (95% CI) for glioma of all combined higher dosages versus the lowest category of dietary nitrite consumption for the following selected studies.
Figure 5
Figure 5
Funnel plot of nitrates and (a) glioma, (b) kidney, and (c) stomach cancer risk; nitrites and (d) colon, (e) pancreatic and (f) bladder cancer risk for publication bias.
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Bryan N.S., van Grinsven H. The role of nitrate in human health. Adv. Agron. 2013;119:153–182.
    1. GBD 2015 Risk Factors Collaborators Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1659–1724. doi: 10.1016/S0140-6736(16)31679-8. - DOI - PMC - PubMed
    1. International Agency for Research on Cancer Ingested nitrate and nitrite, and cyanobacterial peptide toxins. IARC Monogr. Eval. Carcinog. Risks Hum. 2010;94:448. - PMC - PubMed
    1. Ferrucci L.M., Sinha R., Ward M.H., Graubard B.I., Hollenbeck A.R., Kilfoy B.A., Schatzkin A., Michaud D.S., Cross A.J. Meat and components of meat and the risk of bladder cancer in the NIH-AARP Diet and Health Study. Cancer. 2010;116:4345–4353. doi: 10.1002/cncr.25463. - DOI - PMC - PubMed

LinkOut - more resources