Should we say goodbye to pepperoni forever?

Written by: Emily Russo, MS, RD, CDN

Should we say goodbye to pepperoni forever? Are all processed meats bad? Emily Russo, MS, RD, CDN examines the latest science.

Are you concerned about the health risks of processed meats? Can you still enjoy ballpark franks or Sunday bacon with family? Emily answers a reader question about processed meat by examining the evidence, and then sharing her thoughts on how to “process” it all.



ASK EMILY: My husband loves sausage, bacon, hot dogs, and most especially pepperoni. We just recently learned that he has pre-cancerous polyps in his colon. I heard that processed meats could increase the risk for colon cancer, so how do I get him to stop eating them?


First of all, I’m sorry to hear about these recent health developments in your family. Getting news like this can be hard to hear, but he’s lucky to have you by his side. 

I also face these questions and concerns personally as a consumer, a parent, and a daughter. There is so much nutrition information out there, and sometimes it can be overwhelming and scary.  

As polarizing as this topic can be, my intention is to provide you with facts, without a side of judgment. I hope you find it helpful.



  • According to the World Health Organization (WHO), processed meat is defined by transformation through processes such as curing, smoking, salting, fermenting or through flavor enhancements. Examples are bacon, sausage, pepperoni, and canned meats. It is not limited to red meats.
  • The International Agency on Research in Cancer (IRAC), part of the WHO, investigated the findings of over 800 different studies on processed meat and cancer.
  • From these studies, WHO concluded in 2015 that consumption of processed meat was associated with small increases in the risk of colorectal cancer. And, the risk generally increased with the amount of meat consumed.
  • They also concluded from 10 out of those 800 studies, that every 50-gram portion of processed meat eaten daily increases the risk of colorectal cancer by about 18%. A 50-gram portion of meat is 1.6 oz. That’s about two slices of bacon or 21 thin slices pepperoni. Eaten daily.
  • For comparison, the risk of colon cancer related to alcohol use is that ½ ounce ethanol can increase colon cancer risk by 8%. That’s one beer, consumed daily.
  • This information is also shared by the American Cancer Society.



  • The exact compound responsible for this increased risk was not listed in this explanation from the WHO. However, the culprit is likely the chemical used to preserve the meats (nitrates or nitrites, for example). Though not harmful when added to meat, they react with bacteria during digestion and become carcinogenic.
  • It’s not been established if the risk of processed chicken or other white meats is the same as processed red meats.
  • It’s unclear if the amount or type of processing can affect risk, but the more you process, the more chemicals are added and the less nutrients remain.
  • It’s been theorized that if you eat antioxidant-rich fruits and vegetables in the same meal, it may counterbalance the carcinogenic effect. This was not confirmed.
  • It is unlikely that no-nitrate/organically processed/naturally processed meats changes the risk because the vegetarian sources of nitrates used can carry the same risk. But, this was not studied.
  • We don’t know if cooking method changes the risk. This was not confirmed in this review.
  • It is not known if eating processed meat when you already have colon cancer affects cancer growth. This was not studied.



There are many things to consider for your health – and what you eat can be one of them – but what you consume doesn’t have to consume you.

The reason I don’t like to tell people to “eat this” or “don’t eat that” is because getting caught up in that mindset can be more harmful than helpful.

I believe all foods can fit. This is why:

  • Research studies and recommendations on diet are based on intake over a period of time. It’s not relevant to place judgment on one food, one meal, or even one day.
  • So, if you are consistently eating a wide range of foods, you dip your toe in many different food groups, soaking up a variety of vitamins and minerals you need. In turn, you are not putting all your eggs into one basket, or in one food group that may, over time, pose health risks.
  • Though low in the variety of micronutrients we need, processed meats can work in a pinch. They are convenient and have protein and calories to keep a belly full, relatively cheaply and quickly. This may be something as basic as a turkey sandwich.
  • Processed meats may be the only food a family member will eat when they don’t feel well or are going through a picky phase of eating (anyone have kids?). This is okay. Keep in mind, adequacy and nourishment comes first.

Cutting foods out completely can be very challenging because foods have meaning. It may feel like you are cutting out what’s important to your family or even what’s a part of you.

For some, it could be the magic of having a hot dog in a ballpark, or grilled kielbasa on summer nights; it may be Sunday bacon, or Friday night pepperoni pizza.

Eliminating these joyful food memories completely can be sad and stressful, and sadness, stress and eating are not a great combination for health outcomes.  



For those of you who think a loved one may benefit from dietary changes, a word of caution – they can smell your intentions from a mile away.

The more you push your agenda, the more they will pull away. No one wants to be told what to do, especially if they aren’t asking for advice.

Focusing on what you can add, instead of subtract, may have a more positive impact.

This could be as simple as adding fruits, vegetables, and whole grains to meals with sausage or bacon. Luckily, Ann has thought this through already. Two recipes that do the trick are Bacon & Egg Quinoa Fried ”Rice” and the Veggie-Loaded Pasta With Sausage.

The Easy Thai Roast Chicken could be a fun twist and also appeal to those who crave a flavor punch at mealtimes.

Lastly, check out your local butcher. This gives business to your community, and you may learn more about how your meat is processed. Typically, the closer you are to the source, the less processed the meat will be.



In a review of over 800 scientific studies, in 2015 the WHO determined that eating processed meat can cause a small increase in risk for colorectal cancers.

All foods can fit, and even processed meat can be eaten within an overall healthy diet. The key is incorporating variety in total diet and not relying on processed meat as one staple of the diet.

There’s not one perfect diet, food, or meal. Sometimes I eat a turkey sandwich. Sometimes I eat a bratwurst with mustard. They taste good, I enjoy them, and I move on.



The “Ask Emily” column invites you, the reader, to engage more deeply into the nutritional aspects of the blog. All food and nutrition-related questions are welcome. Some will be answered through my column, but I will reply to everyone individually. Click to email me directly.


American Cancer Society. 2019, May 17. How to Interpret News About Cancer Causes.

Cantwell M & Elliott C. 2017. Nitrates, Nitrites, and Nitrosamines From Processed Meat Intake and Colorectal Cancer Risk. Journal of Clinical Nutrition & Dietetics. 3(4) 27.

World Health Organization. 2015, October 26. Cancer: Carcinogenicity of the consumption of red meat and processed meat.



Leave a Reply

Make it? Rate the recipe:

Your email address will not be published. Required fields are marked *


  1. Susan

    I am so glad you addressed this issue. My husband loves Lebanon bologna. We all love pepperoni and bacon! For quite a few years now I have been wondering if we should really be eating these items. I love your common sense philosophy on food. What I take away from this is moderation is key. I will sometimes buy deli turkey rather than Lebanon bologna for sandwiches thinking it is healthier. After reading your post, it seems in terms of the processing the type of meat does not matter. If that is the case, my husband will be delighted!

    1. Emily Post author

      Hi Susan – I’m glad this post resonated with you. None of this is easy, and I certainly don’t have all of the answers. My hope is that by presenting the honest facts, and offering a way to digest them, this will give readers like yourself more clarity and confidence to come to your own conclusions.

      And as my friends and family will tell you, I also have a soft spot for Lebanon bologna, as it reminds me of growing up in the area.

    1. Emily Post author

      Hi Gary – as you must have read in the post, my approach to food is that all things can fit in a healthy diet. Even pepperoni! If you have any questions about this approach, or the nutrition information and research I have presented in this article, please contact me.

  2. Carol Roedel

    This article was extremely helpful and comforting! I have tried to eliminate “bad” foods from our diets completely and it just causes so much stress and crazy cravings! This moderate approach is so workable. Thank you so much for presenting such a sane approach to health!