It might be a little heretical to question the place of bacon on the Paleo menu, but unfortunately, everyone's favorite 'meat candy' really does raise some important health issues. Cured meats in general (not only bacon, but also ham, salami, prosciutto, salami, sausage, and other cured meats) have been a traditional way of preserving animal foods for hundreds of years, but they're also featured in study after study about how all the additives and preservatives in processed meat are dangerous carcinogens.
So are all these foods just another victim of fat-phobic nutritional dogma, or is there actually something to all the accusations?
What Is Cured Meat?
Bearing in mind that there's a difference between mysterious 'lunch meat' and high-quality prosciutto or salami, all cured meats have some points in common. No matter how they're made, many of these products contain organ meats, less-desirable cuts, and various scraps that aren't popular enough to sell in stores. This is actually a benefit, since it reduces waste, and these parts of the animal are often the most nutritious! If a sausage helps you get some more liver into your diet, so much the better.
Whatever part of the animal they're from, cured meats are then seasoned with spices and sugar, and treated with some kind of preservative agent like special curing salt or sodium nitrite. The salt helps prevent the growth of dangerous bacteria, pulls moisture out of the meat (making it more flavorful), and helps to 'cook' the meat via controlled fermentation while it's left alone to cure for weeks or even months. The sugar also aids in the fermentation process, because it provides food for the probiotic bacteria.
There are two main methods of curing: dry curing produces a stronger flavor and it worked better as a preservation method before refrigerators were available; traditional wet curing takes longer, and produces a milder flavor because it allows water to soak into the meat. After curing, some meats (most famously bacon) are then smoked at a low temperature to add even more flavor before making their way onto your plate.
Processed vs. Traditionally Cured
Even though the process sounds similar enough for all kinds of cured meat, there are still substantial differences between the hyper-processed 'luncheon meat' you can get in plastic packages and traditionally cured products like salami and prosciutto.
First off are the ingredients. Many kinds of sausage use every part of the animal, but makers of cheap supermarket bologna often also add soy protein, and inject the product with brine or other additives to plump it up. The same goes for ham. Traditional sausages use animal intestines as the casing, but low-quality brands will often use a variety of artificial 'skins,' up to and including a kind of edible plastic wrap.
Just to showcase the difference, take a product familiar to anyone who's put together a school lunchbox: Oscar Mayer bologna. The ingredients list reads:
Mechanically Separated Chicken, Pork, Water, Corn Syrup, Contains Less Than 2% Of Salt, Sodium Lactate, Flavor, Sodium Phosphates, Autolyzed Yeast, Sodium Diacetate, Sodium Erythorbate (Made From Sugar), Sodium Nitrite, Dextrose, Extractives Of Paprika, Potassium Phosphate, Sugar, Potassium Chloride.
'Flavor' could be just about anything, 'Autolyzed Yeast' is another name for MSG, and 'Dextrose' is a kind of sugar. Yum! Other common additives include food starch (made from potatoes, corn, or other ingredients), various preservatives, and texture enhancers like carrageenan. Oscar Mayer 'bacon bologna' even includes barley, which could be a nasty and unexpected shock for the gluten-intolerant who weren't expecting to find grains in their sausage.
Just for reference, compare that to the ingredients list for making your own bacon:
Pork belly, sea salt, black pepper, rosemary, thyme, fennel seed, bay leaves, garlic, raw honey (optional).
The next difference is the method. Instead of using the time-consuming traditional processes, most cheap cured meat is finished using an accelerated wet-cure method: water is injected under the skin with tiny needles, and then the meat bounced around in a kind of tumbler to distribute the water evenly throughout. The resulting product has a very high water content (more profitable for the manufacturers, since they can buy 4 pounds of pork and sell it as 5 pounds of ham), but it doesn't have the rich, concentrated flavor that come from a real curing process.
That's no problem for the food industry, though. To make up for the bland flavor of the watery meat, food chemists add artificial flavors like liquid smoke, or just assume that since so few people have ever tasted the real thing, they'll simply accept soggy, tasteless ham.
Clearly, there's a massive difference in the health benefits and the taste of supermarket cured meat compared to traditional versions. They're barely even the same food. For the health-conscious, all the cheap processed versions are completely off the table, but what about the real deal: high-quality cured meat with ingredients you recognize, preferably made from grass-fed or pastured animals. Does this kind of 'processed meat' really deserve to be tarred with the same brush as the rest?
Cured Meat: Salt
One of the most common arguments against cured meat is its salt content. Salt is a fundamental part of the curing process – it preserves the meat from infection with dangerous bacteria, assists in the fermentation by good bacteria, and helps dehydrate the meat so that it's safe to store and eat at room temperature. Without salt, the meat might be spiced and aged, but it isn't cured.
Common 'knowledge' about salt would have you believe that a sideways glance at the shaker will send your blood pressure skyrocketing through the roof and put you at risk for a whole host of evils, but this simply isn't true. Even the established medical authorities admit this now, with a study from the National Academy of Sciences earlier this year that reported no significant link between salt intake and high blood pressure or anything else.
So the fear that bacon will strike you dead because of its salt content is completely unfounded, and in fact, the high salt content of cured meats can even be a virtue on a Paleo diet, because sometimes it's hard to get enough salt when you cut out processed junk food. The best way to regulate your salt intake is to eat it exactly to your taste, so if salty cured meat is what you're craving, enjoy it completely without guilt.
Cured Meat: Nitrates and Nitrites
A trickier issue is the nitrate/nitrite content of cured meat – and yes, even high-quality meat with real ingredients is often cured with them (usually nitrites, since they're more predictable and work faster). Meat labeled 'no added nitrates or nitrites' is usually just made with celery juice, which contains naturally-occurring versions of the exact same chemicals.
A point that's often missing in this discussion is that these chemicals are not there just for fun. They're added to prevent the growth of bacteria that produce botulinum toxin. By weight, botulinum toxin is the most poisonous chemical compound that we know of: it's 100,000 times more dangerous than Sarin, a chemical weapon banned under international law. Just a tiny dose causes botulism, a progressive failure in the muscles and nervous system leading to paralysis and death.
Clearly, this is not a danger to mess around with. But how much of a risk does it really pose? In the United States, a CDC report found 263 cases of foodborne botulism between 1990 and 2000. Judging from this, you might think that foodborne botulism is so vanishingly rare that it's not worth worrying about. And if you just look at the lower 49 states (160 cases), you'll see a long list of culprits, only 3 of which involved homemade sausage. So at first glance, it seems that the risk from botulism poisoning is absolutely tiny, and not significantly associated with cured meat.
But a glance at Alaska tells a different story. Of the 263 cases, 103 occurred in Alaska. So 39% of the cases occurred among 1.5% of the population. What were Alaskans doing differently? Eating traditional home-cured foods. Of those 103 cases:
- 20 involved seal oil
- 18 involved fish eggs
- 21 involved 'fermented sea mammals'
- 28 involved fermented fish
- The others involved unknown or mixed ingredients.
So where home-curing and home-fermentation is common (among Alaska natives), botulism is also common. The only reason why it's so rare in the other 49 states is that so few people cure their own food, and the vast majority of cured meat is treated with nitrites to prevent it. The bottom line: botulism is a serious danger from cured meat, and nitrites are an effective way to prevent it.
So bearing in mind that nitrates and nitrites are not just being thrown into your bacon for no good reason, do they have dangers as well as benefits? These chemicals are most infamous as carcinogens: they've been blamed for cancer of the stomach, colon, and pancreas, and they're occasionally even implicated in brain tumors, cardiovascular diseases, and all kinds of other problems.
However, the risks of nitrates and nitrites may have been vastly overstated. This article and this one are good places to start your research, and here's a free full-text from the American Journal of Clinical Nutrition outlining the issue. A quick summary: in your body, nitrates get converted to nitrites, so whether you're eating meat cured with nitrates or nitrites really doesn't matter, because they all get metabolized into nitrites anyway. And there's just no evidence that nitrites are dangerous – not to mention that cured meat provides a relatively tiny proportion of our total nitrite intake. Most of your body's nitrite supply comes from your own saliva, and among foods, vegetables are by far the richest source. So if bacon is deadly because of the nitrites, then spinach must be even deadlier! There are even some attested benefits for blood pressure, and ability to use energy during exercise.
That said, it's also true that for certain groups of people, eating nitrates and nitrites can be bad news for non-cancer reasons. Some of us just have a nitrate/nitrite sensitivity, for some individual reason. And they're also commonly known as migraine triggers. But for people who don't react to them, there isn't convincing evidence suggesting that they're dangerous.
Cured Meat: Nitrosamines
Then there's the nitrosamine issue. Nitrates and nitrites don't stick around in that form for long – all the nitrates become nitrites, and then the nitrites are either converted into nitric oxide (harmless, and even has some health benefits) or nitrosamines (dangerous carcinogens). This conversion can either take place in the food itself, or in your body as you're digesting the food. The difference is clearly important, so how do you wind up with one or the other?
Enter the antioxidants. Remember that vegetables (not meat) are actually the biggest source of nitrites in most people's diets – the nitrites from vegetables are actually one of their health benefits, because the naturally-occurring antioxidants (Vitamins C and E) convert them into nitric oxide instead of toxic nitrosamines.
For this reason, all commercial bacon is required to be processed with antioxidants. If you see 'sodium ascorbate' or something similar on the package, don't roll your eyes at another useless additive, because that's just another name for Vitamin C (ascorbic acid), and it's actually making the bacon safer to eat. The same goes for 'sodium erythorbate,' another antioxidant (if you look back up at the Oscar Mayer ingredients list, you'll see this one). So even in cheap grocery-store bacon, there's not much danger of the nitrites being metabolized into nitrosamines.
In traditionally cured meats, you can tell that the nitrates and nitrites are forming nitric oxide during the curing process, because that's what gives cured meat its darker pink color relative to the uncured meat (it's also how you can tell truly nitrite-free bacon: it will be darker brown to black on the outside rather than pink or red).
Ultimately, you're not getting any appreciable amount of nitrosamines from processed meat, even if it is cured with nitrites. What about the potential to form them in your own body? That's why you have your own endogenous antioxidants. These antioxidants promote the conversion of all ingested nitrates and nitrites (including the ones in your saliva and in vegetables) to nitric oxide, rather than nitrosamines.
Nitrates, Nitrites, and Nitrosamines: The Bottom Line
If all this is true, then why do so many authorities warn against the carcinogenic dangers of nitrates and nitrites? There certainly are plenty of epidemiological studies proving an association between processed meat consumption and all different kinds of cancers, but considering that most people are eating junk food supermarket bacon (full of all kinds of other nasty things), this doesn't provide any evidence that the nitrites themselves are dangerous.
Then there's the healthy user bias: if you tell people for years that bacon will kill them, the people who take care of themselves in other ways (exercising, not smoking, etc.) will all stop eating bacon. In the bacon-eating group, you'll be left with the people who just don't care about their health at all – again, this does nothing to prove that the bacon specifically is a problem.
As well as epidemiological studies in humans, there are also plenty of animal studies where researchers dosed rats with absurd amounts of nitrates and nitrites, but even in those concentrations, the chemicals didn't cause cancer unless they were also accompanied by another carcinogen. So avoid bacon-flavored cigarettes and you should be fine.
Ultimately, there just isn't much to stress over from the nitrate/nitrite/nitrosamine issue. Avoid them if they cause problems for you personally; don't worry about them if they don't.
Getting Quality Cured Meat
In the supermarket, your chances of finding high-quality sausages and ham is pretty slim. If you have a specialty foods store, you might be able to find brands with recognizable ingredients, but your best bet is to either buy directly from a butcher, or make your own.
Curing your own meat is surprisingly easy, and actually a pretty entertaining hobby. For starters, check out our recipe for making your own home-cured bacon. If you're eager for more, recipes for other kinds of charcuterie are available all over the internet; you can find some great ones here at Hunter Angler Gardener Cook. That site is run by a man who does a lot of his own hunting and gathering, and uses charcuterie as a functional way to keep the meat safe.
Another word about nitrites: some people still aren't persuaded that nitrites are harmless, and seize the chance to cure their own meat because it lets them create a nitrite-free product. To accomplish this, simply avoid the pink curing salt recommended by most home-cured bacon recipes, and use kosher salt or regular table salt in its place. But if you go this route, it's just important to be very careful. Remember that the nitrites are there for a reason; if you're doing without, you'll want to make sure to take the appropriate precautions to prevent botulism.
The bacteria that carry botulinum toxin grow best at room temperature, so make very sure to keep the meat refrigerated for the entire time. Also take care to cook the final result thoroughly at a high temperature: the botulism toxin can be destroyed by very high temperatures, so if there's any lurking in your final product, you can destroy it this way. Do not use nitrite-free curing on any meat you don't plan to cook, like bologna or salami. There is no way to test for it outside a lab, so the meat may still be dangerous even if it looks, smells, and tastes fine. Unless you have a well-documented sensitivity, it really is safer and easier to just use curing salt.
Cooking With Cured Meat
Once you have your cured meat, the fun part starts. While ham, sausages, and bacon are traditional as main dishes, it's also interesting to think of cured meat like a condiment or snack, rather than a main course. Used creatively, it can add its flavor to all kinds of dishes, making a little bit of meat stretch out into a lot of taste. Some ideas:
- Add it to soup for a rich, smoky flavor: a ham bone is traditional, but you could also use a few strips of bacon or some chopped sausage.
- Crumble bacon over a soup or salad as a garnish – or add it to the salad for its own sake.
- Crisp up a few slices of bacon and make some BLT dressed eggs.
- Flavor mayonnaise with bacon.
- Stuff a steak (or anything else) with prosciutto or another cured meat.
- Fill ham slices with eggs for Paleo Eggs Benedict.
Slices of sausage or other cured meats are also a handy portable snack food: they'll keep all day in a lunchbox or another container at room temperature, although for long-term storage you'll need to either take the entire sausage, or refrigerate the slices.
Conclusion
Is cured meat healthy? That really depends. Low-quality cured meat should absolutely be avoided, even if your choice is low-quality bacon or low-quality chicken breast. In this case, your best bet is to buy lean grocery-store meat and add healthy fats at home.
If you're making your own, and you know exactly what's going into it, charcuterie can be just as healthy as any other meat. After all, pork belly is a perfectly healthy food to start with; there's nothing about rubbing it with spices and salt, letting it sit in the fridge, smoking it, or cooking it that magically transforms it into a nutritional demon.
In the end, cured meat falls into the category of foods that are perfectly healthy, delicious, and nutritious in reasonable amounts and as long as they don't replace other staples. If you eat nothing but salami, you'll get sick (although you'll probably get sick of salami first). But that applies to pretty much any food. Eating some cured meat in the context of a varied and nutritious diet is perfectly fine – and if it helps you get excited about where your food is coming from and how it's made, so much the better.
