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Cited by 4Nutritional Studies and DietPhytochemicals and Antioxidant ActivitiesHead and Neck Cancer Studies

The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.

Association of dietary nitrate and nitrite from plant sources with digestive system cancer risk: a systematic review and meta-analysis

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Long, Bangce, Jiang, Chenglin, Liu, Zhongjian, Wan, Ping, Guo, Qiang·2025·Nutrition & Metabolism
DOI 10.1186/s12986-025-00973-6PMC PMC12297779
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Abstract

BACKGROUND: Recent studies have indicated that dietary nitrate intake from plant sources offers numerous health benefits. However, the relationships between the intake of plant-derived nitrates and nitrites and the risk of digestive system cancers (DSCs) remain unclear. This study aimed to quantify the associations between dietary nitrate and nitrite from plant sources and the risk of DSCs via a systematic review and meta-analysis. METHODS: We conducted extensive literature searches of the PubMed, Embase, Scopus, Web of Science, CINAHL, Cochrane Library, CNKI, VIP, Wanfang, and CBM databases up to April 2024. STATA 14.0 was applied for meta-regression and meta-analysis, and fixed or random effects models were used to calculate the pooled relative risks and 95% confidence intervals. Sensitivity and subgroup analyses were conducted to explore sources of heterogeneity. RESULTS: Our analysis included 13 articles with a total of 897,585 participants, which included 10 different types of digestive tumors. The pooled results indicated no significant association between high (median: >134.9 mg/day) [RR = 0.92; 95% CI (0.82-1.03); P = 0.14] or moderate (median: 83.0-133.1 mg/day) [RR = 0.95; 95% CI (0.89-1.02); P = 0.186] nitrate intake and DSCs. Similarly, neither high (median: >0.91 mg/day) [RR = 0.91; 95% CI (0.84-1.00); P = 0.05] nor moderate (median: 0.75 mg/day) [RR = 0.96; 95% CI (0.89-1.04); P = 0.355] nitrite intake was correlated with DSCs. However, a negative association was observed between nitrate or nitrite intake and DSCs when the data were stratified by subgroup variables such as study type, sex, region, antioxidant intake, and fibre intake. A meta-regression dose‒response analysis revealed that the risk of gastric cancer was negatively associated with the median intake of plant-derived nitrates [slope= -0.0047 per mg/day; 95% CI (-0.0086--0.0008); P = 0.022]. CONCLUSIONS: Plant-derived nitrate and nitrite intakes were not significantly associated with DSCs. This relationship may be affected by subgroup variables, and a dose‒response analysis indicated that higher nitrate intake was linked to a reduced risk of gastric cancer.

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  • Nitrate and nitrite have historically been associated with potential toxic effects, including the risk of methaemoglobinaemia.

    “Beyond nitrosamine formation, nitrate and nitrite have also historically been associated with potential toxic effects, including the risk of methaemoglobinaemia [278,279,280].”

    From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [280]

    The Introduction (page unavailable) says nitrate and nitrite were historically considered detrimental because they can form nitrosamines associated with cancer. It does not mention methaemoglobinaemia or identify a toxic effect beyond nitrosamine formation; searches for methaemoglobinaemia and methemoglobinemia found no such passage. (LLM, conf=0.85)

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  • Nitrate from vegetables, which represent the main dietary source, has not been associated with an increased cancer risk and may even demonstrate protective properties in meta-analyses.

    “Nitrate from vegetables, which represent the main dietary source, has not been associated with an increased cancer risk and may even demonstrate protective properties in meta-analyses [278,279,280].”

    From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [280]

    The Introduction identifies vegetables as accounting for approximately 80–90% of dietary nitrate intake. The Conclusion reports no greater risk of digestive cancers with plant-derived nitrate intake, and the Meta-regression reports a possible protective association for gastric cancer. The claim's unqualified reference to cancer risk is broader than the cancers this review assessed. (LLM, conf=0.87)

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Research works printed but not linked: 1

  1. Shariatpanahi SN, Hoodaji M, Mahmoudi M, Navaei RA, Atooe MT. Evaluation of nitrate status in drinking water and vegetables of Savadkuh and Simorgh counties and its relationship with the prevalence of Gastrointestinal cancers. J Environ Stud. 2022;47(4):445–60.

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Metadata

Authors
Long, B., Jiang, C., Liu, Z., Wan, P., & Guo, Q.
Affiliations
  • Kunming University of Science and Technology (CN)
  • First People's Hospital of Yunnan Province (CN)
Corresponding author
Guo, Qiang
ORCID
Venue
Nutrition & Metabolism
Publisher
Springer Science and Business Media LLC
Published
2025-07-25
Volume
22
Issue
1
Pages
84-84
ISSN
1743-7075 (ISSN-L)
DOI
10.1186/s12986-025-00973-6
PMC
PMC12297779
OpenAlex
W4412707813
Cited by
4
References
53
Citations by year
2026: 3 · 2025: 1
FWCI
0.77
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition & Metabolism (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
High level Talent Project of Yunnan Province (2023-KHRCBZ-A04)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Biochemistry (medical) › Phytochemicals and Antioxidant Activities
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
Keywords
dietary nitrate, dietary nitrite, gastrointestinal cancer, gastric cancer, colorectal cancer, cancer risk, dose-response relationship, fibre intake, antioxidant intake, cancer prevention, chemoprevention, oncological outcomes, cancer mortality, cancer incidence, cancer survival, tumor recurrence, cancer risk factors, cancer risk reduction

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