I have seldom been so happy to get an email. Last year, the National Cancer Institute in the US replied to my request for an expert opinion on something that had been bothering me for a long time. My question was: are sausages really processed meat?
The email from the NCI – based on the considered views of two leading American epidemiologists – confirmed that, contrary to what almost every newspaper says, not to mention the World Health Organization, fresh sausages were not in fact processed meat. So long as the sausage meat was made from fresh mince and there were no additives except for breadcrumbs and herbs, with no nitrates and nothing smoked, these cancer scientists replied that “one might consider it red meat”.
This news sent me dancing round the kitchen with delight. I don’t eat sausages every day or even every week, but I consider sausages and mash to be the highest form of comfort food on a cold day, especially when served with Nigel Slater’s recipe for onion gravy, rich with Marsala. I’m also not averse to the crispy delights of a toad-in-the-hole or a rich tomatoey sausage and fennel sauce to go with conchiglie (I love the way the crumbled pieces of sausage nestle in the pasta shells).
But like so many pleasures in modern life, my occasional dish of sausages had become tinged with unease. Over the past couple of years, I’d read multiple news stories insisting that sausages are processed meat and that regular consumption would definitely raise the risk of bowel cancer. Much as I like sausages, I wasn’t so keen on the nagging sensation that I might be serving up cancer on a plate to my family. As food writer Ruby Tandoh has written, it’s sad that sausages have become seen as something to fear given that “we can’t all afford sirloin steaks or corn-fed chicken for dinner every day”.
The idea that all sausages are processed meat and therefore best eaten sparingly, if at all, was given official backing in 2015. That year, the World Health Organization made a high-profile announcement that processed meats were now classified as a group 1 carcinogen. After reviewing more than 400 studies, WHO scientists were convinced there was enough evidence to say that these meats caused colon cancer. “Examples of processed meat,” stated the WHO, include “hot dogs (frankfurters), ham, sausages, corned beef, and biltong or beef jerky as well as canned meat and meat-based preparations and sauces.” The WHO advised that consuming 50g of processed meat a day – less than two average-sized sausages – would raise the risk of getting bowel cancer by 18 per cent over a lifetime.
Debate still rages among scientists as to why processed meats are more clearly carcinogenic than unprocessed meats. The likeliest explanation seems to be the use of nitrites and nitrates: chemicals used in the curing of bacon and salami that speed up the process and keep the meat pink. Nitrates themselves are not poisonous. After all, there are nitrates in green vegetables and no one is telling us to stop eating those. But when nitrates interact with certain chemicals in red meat they form N-nitroso compounds in the gut such as nitrosamine, and there is no doubt that these chemicals cause cancer.
Many food campaigners now argue that, given the risk to consumers, the use of these nitro-chemicals to cure meat is inexcusable. One of these campaigners is French journalist Guillaume Coudray, author of a hard-hitting 2016 expose of the processed meat industry called Cochonneries, a French word that means both “junk food” and “piggeries”. Coudray feels that when discussing the cancer risks involved in eating processed meat, we should really be referring to “nitro-meat”.
But a fresh British sausage is not nitro-meat. So why is it wrongly categorised as processed meat by almost everyone? I suspect that the mistake arose from translation issues. The French word saucisse often refers not to a fresh sausage but to a hard stick of salami or a smoked and nitrate-cured frankfurter. The continental versions of sausage are invariably cured using nitrates and nitrites; think of a Polish swojska or a Spanish chorizo. By contrast, the vast majority of sausages in Britain are made with nothing but fresh minced meat, breadcrumbs, seasoning and herbs. When it comes to cancer risks, a British banger should be seen as equivalent to spaghetti bolognese rather than to bacon (which sadly – don’t shoot me – really is processed meat).
I’m not saying that sausages are kale, let alone anything that Gwyneth Paltrow would approve of. There are still plenty of arguments against sausages, such as the fact that the world’s meat habit is unsustainable. Nor are sausages entirely risk-free on the health front. The press officer from the NCI was keen to impress on me that red meat, even when unprocessed, is still “deemed to be a probable human carcinogen” and that an individual person’s risk from consuming red meat “depends on many factors”. If the spokesperson was trying to rain on my parade, he didn’t succeed. For now, I’ll eat my sporadic sausage suppers with joy, which is the best way to eat anything.