Catherine P. Bondonno
Nicola P. Bondonno
Trends in Food Science and Technology
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
Royal Perth Hospital Medical Research Foundation ‘Lawrie Beilin’ Career Advancement Fellowship (ID: CAF 127/2020) / Australian Government Research Training Program (AGRTP) / National Health and Medical Research Council (NHMRC) of Australia Early Career Fellowship and Australia Emerging Leadership Investigator Gran / Research project ‘Dietary Nitrate, Vascular Function and Inflammation’ (ClinicalTrials.gov Identifier: NCT04584372), funded by the Austrian Science Fund–FWF (FWF project no. KLI 585) / National Heart Foundation of Australia Post-Doctoral Research Fellowship (ID: 102498)
NHMRC Numbers : APP1159914, 1172987
Background: Dietary nitrate has a controversial role in human health. For over half a century, the nitrate content of the three major dietary sources – vegetables, meat, and water – has been legislated, regulated, and monitored due to public health concerns over cancer risk. In contrast, a growing and compelling body of evidence indicates that dietary nitrate, particularly from vegetables, protects against cardiovascular disease and other chronic diseases. This evidence for the protective effect of nitrate is overshadowed by the potential for nitrate to form carcinogenic N-nitrosamines. Scope and approach: The nitrate content, regulations and estimated intake from vegetables, meat and water are described. The evidence that nitrate, through its effects on nitric oxide, improves cardiovascular disease outcomes, cognitive health, musculoskeletal health, and exercise performance as well as the potential to protect against other debilitating health outcomes (nitrate as Dr Jekyll) is discussed. The underlying assumption that all nitrate, irrespective of source, leads to the formation of carcinogenic N-nitrosamines and the evidence of an association between the different sources of nitrate and cancer (nitrate as Mr Hyde) is examined. Key findings and conclusions: The current theory that nitrate, is a carcinogenic contaminant in meat, water, and vegetables is not fully supported by available evidence. Definitive studies examining the beneficial or harmful effects of source-dependent nitrate have yet to be performed. Studies with improved exposure assessment and accurate characterization of factors that affect endogenous nitrosation are also needed to draw conclusions about risk of cancer from dietary nitrate intake.
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