Author Identifier
Nicola Bondonno
https://orcid.org/0000-0001-5905-444X
Pratik Pokharel
https://orcid.org/0000-0001-5815-5927
Catherine Bondonno
https://orcid.org/0000-0001-8509-439X
Liezhou Zhong
https://orcid.org/0000-0002-6847-4240
Jonathan Hodgson
https://orcid.org/0000-0001-6184-7764
Lauren Blekkenhorst
Document Type
Journal Article
Publication Title
European Journal of Epidemiology
Volume
39
First Page
925
Last Page
942
PubMed ID
38802612
Publisher
Springer
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
RAS ID
70248
Funders
Kræftens Bekæmpelse
Grant Number
1172987
Abstract
Introduction: Nitrate and nitrite are naturally occurring in both plant- and animal-sourced foods, are used as additives in the processing of meat, and are found in water. There is growing evidence that they exhibit a spectrum of health effects, depending on the dietary source. The aim of the study was to examine source-dependent associations between dietary intakes of nitrate/nitrite and both all-cause and cause-specific mortality. Methods: In 52,247 participants of the Danish Diet, Cancer and Health Study, associations between source-dependent nitrate and nitrite intakes––calculated using comprehensive food composition and national drinking water quality monitoring databases––and all-cause, cardiovascular disease (CVD)-related, and cancer-related mortality over 27 years were examined using restricted cubic splines within Cox proportional hazards models adjusting for demographic, lifestyle, and dietary confounders. Analyses were stratified by factors hypothesised to influence the formation of carcinogenic N-nitroso compounds (namely, smoking and dietary intakes of vitamin C, vitamin E, folate, and polyphenols). Results: Plant-sourced nitrate intake was inversely associated with all-cause mortality [HRQ5vsQ1: 0.83 (0.80, 0.87)] while higher risks of all-cause mortality were seen for higher intakes of naturally occurring animal-sourced nitrate [1.09 (1.04, 1.14)], additive permitted meat-sourced nitrate [1.19 (1.14, 1.25)], and tap water-sourced nitrate [1.19 (1.14, 1.25)]. Similar source-dependent associations were seen for nitrite and for CVD-related and cancer-related mortality except that naturally occurring animal-sourced nitrate and tap water-sourced nitrate were not associated with cancer-related mortality and additive permitted meat-sourced nitrate was not associated with CVD-related mortality. No clear patterns emerged in stratified analyses. Conclusion: Nitrate/nitrite from plant sources are inversely associated while those from naturally occurring animal-sources, additive-permitted meat sources, and tap water-sources are positively associated with mortality.
DOI
10.1007/s10654-024-01133-5
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Bondonno, N. P., Pokharel, P., Bondonno, C. P., Erichsen, D. W., Zhong, L., Schullehner, J., ... & Olsen, A. (2024). Source-specific nitrate intake and all-cause mortality in the Danish diet, cancer, and health study. European Journal of Epidemiology, 39, 925-942. https://doi.org/10.1007/s10654-024-01133-5