Review: Putative mutagens and carcinogens in foods. I. Nitrate/nitrite ingestion and gastric cancer mortality

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Abstract
Published figures for per capita daily levels of nitrate ingestion in the 1970s are compared with gastric cancer mortality estimates for the same period. A strong positive correlation is observed in 12 countries, not only when the data are analyzed as a linear—linear function, as illustrated in this paper, but also when the relationship is analyzed as a function of (nitrate)2. This correlation supports the concept that important components of gastric cancer induction are the in vivo bacterial reduction of nitrate to nitrite and the intragastric formation of mutagenic/ carcinogenic nitroso, and possibly nitro compounds. Data are summarized from a recent National Academy of Sciences [1981] study that enumerates by individual dietary sources the mean ingestion of nitrate and nitrite by the United States population at the present time. The ingestion figures are used to calculate the probable current gastric nitrite load in US adults with normal gastric acidity. Similar calculations are provided for past years (1925, 1936–1937, and 1971–1972). Since 1925, there has been an approximately threefold decrease in gastric cancer mortality in the US, and this decline is paralleled by an approximately fourfold decrease in average gastric nitrite load. The excessive ingestion of nitrate/ nitrite in the US in past years is attributed to the very high content of nitrate and nitrite in cured meats. Several ways compatible with current US farming and marketing practices that are capable of reducing the gastric nitrite load even further are pointed out.