title: Intake and food sources of nitrites and N-nitrosodimethylamine in Spain.
abstract: OBJECTIVE
  To conduct a comprehensive assessment of dietary intakes of nitrites and N-nitrosodimethylamine (NDMA).
  
  
  METHODS
  A study was conducted within the Spanish cohort of the European Prospective Investigation in Cancer and Nutrition (EPIC) to assess the intake and food sources of these compounds in Spanish adults. The study included 41,446 health volunteers, aged 29-69 years, from Northern and Southern regions. Usual food intake was estimated by in-person interviews using a computerised dietary questionnaire.
  
  
  RESULTS
  The estimated geometric mean was 0.994 mg day(-1) for nitrites and 0.114 microg day(-1) for NDMA. For both compounds a positive trend in consumption with increasing energy intake was observed. Dietary NDMA was related to age and sex after energy adjustment, while nitrite consumption increased with higher intakes of vitamin C (P < 0.001). The food groups that contributed most to intakes were meat products, cereals, vegetables and fruits for nitrites, and processed meat, beer, cheese and broiled fish for NDMA. Current and past smokers, who had high levels of NDMA from tobacco exposure, were also identified as the highest consumers of dietary NDMA. Furthermore, smokers had low intakes of vitamin C (an inhibitor of endogenous nitrosation).
  
  
  CONCLUSIONS
  Intake levels of NDMA and nitrites in a Mediterranean cohort are currently relatively lower than those previously reported, although processed meat, beer and cured cheese still are the most important contributors to NDMA intake.
authors.affiliation: Institut Català d'Oncologia (ICO-IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain. paujak@iconcologia.catsalut.net
authors.forename: Paula
authors.initials: P
authors.lastname: Jakszyn
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: Antonio
authors.initials: A
authors.lastname: Berenguer
authors.forename: Raquel
authors.initials: R
authors.lastname: Ibáñez
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Carmen
authors.initials: C
authors.lastname: Martinez
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: José R
authors.initials: JR
authors.lastname: Quirós
authors.forename: María José
authors.initials: MJ
authors.lastname: Sanchéz
authors.forename: María José
authors.initials: MJ
authors.lastname: Tormo
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000818:Animals; D002611:Cheese / Q000009:adverse effects / Q000032:analysis; D015331:Cohort Studies; D004032:Diet; D004034:Diet Surveys; D002149:Energy Intake; D005260:Female; D005504:Food Analysis; D005511:Food Handling / Q000379:methods; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects / Q000032:analysis; D008875:Middle Aged; D009573:Nitrites / Q000008:administration & dosage* / Q000032:analysis*; D009602:Nitrosamines / Q000008:administration & dosage* / Q000032:analysis*; D011446:Prospective Studies; D017678:Sex Distribution; D012907:Smoking; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D009573:Nitrites; D009602:Nitrosamines; C025033:N-amyl-N-methylnitrosamine