Human safety controversies surrounding nitrate and nitrite in the diet

Nitrate and nitrite are part of the human diet as nutrients in many vegetables and part of food preservation systems. In the 1950s and 1960s the potential for formation of nitrosamines in food was discovered and it ignited a debate about the safety of ingested nitrite which ultimately focused on cured meats. Nitrate impurities in salt used in the drying of meat in ancient times resulted in improved protection from spoilage during storage. This evolved into their deliberate modern use as curing ingredient responsible for 'fixing' the characteristic color associated with cured meats, creating a unique flavor profile, controlling the oxidation of lipids, and serving as an effective antimicrobial. Several critical reports and comprehensive reviews reporting weak associations and equivocal evidence of nitrite human health safety have fostered concerns and debate among scientists, regulators, press, consumer groups, and consumers. Despite periodic controversy regarding human health concerns from nitrite consumption, a building base of scientific evidence about nitrate, nitrite, heme chemistry, and the overall metabolism of nitrogen oxides in humans has and continues to affirm the general safety of nitrate/nitrite in human health. As nitrite based therapeutics emerge, it is important to consider the past controversies and also understand the beneficial role in the human diet.