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Prospective study of meat intake and dietary nitrates, nitrites, and nitrosamines and risk of adult glioma^1,2,3

¹ From the Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom (DSM); the Department of Epidemiology, Harvard School of Public Health, Boston, MA (DSM, EG, and DJH); i3 Drug Safety, Waltham, MA (CNH); the Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA (TB); the Department of Nutrition, Harvard School of Public Health, Boston, MA (EG); and the Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (EG and DJH).

² Supported by grant CA110948 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services.

³ Address correspondence to DS Michaud, Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, UG 43, St Mary’s Campus, Norfolk Place, London, W2 1PG, United Kingdom. E-mail: d.michaud{at}imperial.ac.uk.

Background: The hypothesis that nitrosamine exposure may increase the risk of glioma has been circulating for several decades, but testing it has been difficult because of the ubiquitous nature of nitrosamine exposure. Diet has been the focus of many studies because it can substantially influence nitrosamine exposure, mostly from the endogenous formation of nitrosamines based on intake of nitrite and nitrate.

Objective: The objective was to examine the relation between intakes of meats, nitrate, nitrite, and 2 nitrosamines [nitrosodimethylamine (NDMA) and nitrosopyrolidine (NPYR)] and glioma risk in a prospective analysis.

Methods: Data from 3 US prospective cohort studies were combined for this analysis; 335 glioma cases were diagnosed during 24 y of follow-up. Dietary intake was assessed with food-frequency questionnaires. Nitrate, nitrite, and nitrosamine values were calculated based on published values of these nutrients in various foods over different periods in time. Cox proportional hazards models were used to estimate incidence rate ratios (RRs) and 95% CIs. Estimates from each cohort were pooled by using a random-effects model.

Results: Risk of glioma was not elevated among individuals in the highest intake category of total processed meats (RR: 0.92; 95% CI: 0.48, 1.77), nitrate (RR: 1.02; 95% CI: 0.66, 1.58), nitrites (RR: 1.26; 95% CI: 0.89, 1.79), or NDMA (RR: 0.88; 95% CI: 0.57, 1.36) compared with the lowest category. No effect modification was observed by intake of vitamins C or E or other antioxidant measures.

Conclusion: We found no suggestion that intake of meat, nitrate, nitrite, or nitrosamines is related to the risk of glioma.