Citation: Vrani´ c, D.; Mileševi´ c, J.;
Trbovi´ c, D.; Gurinovi´ c, M.; Kori´ canac,
V.; Zekovi´ c, M.; Petrovi´ c, Z.;
Rankovi´ c, S.; Mili´ cevi´ c, D. Exposure
to Phosphates and Nitrites through
Meat Products: Estimation of the
Potential Risk to Pregnant Women.
Nutrients 2023, 15, 2777. https://
doi.org/10.3390/nu15122777
Academic Editor: Shannon
L. Kelleher
Received: 19 April 2023
Revised: 1 June 2023
Accepted: 14 June 2023
Published: 16 June 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
nutrients
Article
Exposure to Phosphates and Nitrites through Meat Products:
Estimation of the Potential Risk to Pregnant Women
Danijela Vrani´ c
1
, Jelena Mileševi´ c
2
, Dejana Trbovi´ c
1
, Mirjana Gurinovi´ c
2
, Vladimir Kori´ canac
1
,
Milica Zekovi´ c
2
, Zoran Petrovi´ c
1
, Slavica Rankovi´ c
2
and Dragan Mili´ cevi´ c
1,
*
1
Institute of Meat Hygiene and Technology, Ka´ canskog 13, 11040 Belgrade, Serbia;
danijela.vranic@inmes.rs (D.V.); dejana.trbovic@inmes.rs (D.T.); vladimir.koricanac@inmes.rs (V.K.);
zoran.petrovic@inmes.rs (Z.P.)
2
Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute
of Republic of Serbia, University of Belgrade, Tadeuša Koš´ cuška 1, 11000 Belgrade, Serbia;
jelena.milesevic@gmail.com (J.M.); mirjana.gurinovic@gmail.com (M.G.); zekovicmilica@gmail.com (M.Z.);
slavica.rankovic.imr@gmail.com (S.R.)
* Correspondence: dragan.milicevic@inmes.rs
Abstract: Diet during pregnancy is one of the most important nutritional challenges associated with
some risks for the mother and the fetus. For the first time, the study aims to estimate long-term
(2018–2022) exposure to nitrate and phosphates in Serbian pregnant women, based on individual
consumption data and accurate values measured in frequently consumed meat products. For this
purpose, seven types of meat products, consisting of 3047 and 1943 samples, were collected from
retail markets across Serbia, to analyze nitrites and phosphorus content, respectively. These data were
combined with meat product consumption data from the Serbian National Food Consumption Survey
to assess dietary intake of nitrites and phosphate. The results were compared with the acceptable
daily intake (ADI) proposed by the European Food Safety Authority. The average dietary exposure
(EDI) to phosphorus ranged from 0.733 mg/kg bw/day (liver sausage and pate) to 2.441 mg/kg
bw/day (finely minced cooked sausages). Considering nitrite intake, the major sources were bacon
(0.030 mg/kg bw/day) and coarsely minced cooked sausages (0.0189 mg/kg bw/day). In our study,
average nitrite and phosphorus exposure in the Serbian pregnant women population are far below
the EFSA recommendations (ADI 0.07 mg/kg bw/day and 40 mg/kg bw/day, respectively).
Keywords: food additives; nitrites; phosphates; pregnant women; meat products; exposure assessment
1. Introduction
Even though meat and meat products are one of the most important contributors
of the modern diet, it is well known that the nutritional profile of processed meat has
been perceived as unhealthy due to the high levels of saturated fatty acids, cholesterol [1],
or components that could be considered with negative health impacts (sulfites, nitrites,
and sodium). Moreover, elevated consumption of processed meat and red meat has been
associated with cardiovascular diseases, colorectal, stomach, prostate, and pancreatic
cancer [2]. According to an epidemiological study, processed meat has been classified as
carcinogenic to humans (Group 1) while red meat is probably carcinogenic to humans
(Group 2A) [3]. Because of this, there is growing interested in the processed meat industry
to reduce food additives that could be considered unhealthy [4].
Nitrates and nitrites (E249–E252) are food additives of concern for humans’ health
because they may interact with secondary amines in the stomach, producing nitritesN-
nitroso compounds (N-NAs), which could play a role in the carcinogenicity of processed
meat [5,6]. Among meat products, cured meats often contain detectable levels of N-NAs
mainly due to the use of nitrites as a preserving agent, additionally influenced by several
Nutrients 2023, 15, 2777. https://doi.org/10.3390/nu15122777 https://www.mdpi.com/journal/nutrients