Worried about the carbs in that sandwich? There may actually be bigger issues to worry about.

By Carolyn Williams, PhD, RD
September 04, 2018
Photo: Caitlin Bensel

According to national food surveys, 47% of Americans eat at least one sandwich each day, the most frequent type being those made with cold cuts or deli meats—not much of a surprise given their convenience and our busy lifestyles. But it is surprising that most of those smoked turkey or oven-roasted ham slices are classified as “processed meats”—a category of food that’s been linked to heart disease and cancer.

Sure, we know it’s good to minimize processed meats like bacon, sausage and hot dogs, but are deli meats really something we should be eating less of? And should we be concerned about potential health risks? Here’s what you need to know.

Are deli meats processed?

Technically, all meat is processed in some form since it’s got to be cooked to eat, but the term “processed meats” specifically refers to any meat, pork, poultry or other animal protein that has been altered through a process like salting, curing, preserving, fermentation, or other method to improve flavor, extend shelf-life, and slow or prevent harmful bacteria development.

The category of processed meats is large and includes foods like bacon, sausage, marinated meats, cured meats, smoked meats or poultry, hot dogs, cold cuts and deli meats, but also includes both ready-to-eat meats and those that still need to be cooked before consuming.

What are the health concerns?


Processed meats have higher sodium contents due to the salting, curing, or preservation methods used. While it’s the sodium in these methods that prevents the growth of harmful bacteria growth, excess sodium contributes to high blood pressure, as well as heart attacks, strokes, and cardiovascular diseases.

Potential Cancer Risk

The International Agency for Cancer Research (IACR) released a report in 2015 that confirmed a potential link between processed meats and cancer risk. This risk is small, especially when compared to risk factors like smoking, but the risk increases the more you eat. Researchers haven’t pinpointed one specific ingredient or processing additive as the main culprit that increases this risk, but many like to speculate it's related to compounds called nitrates.

Salts like sodium nitrite are used often used in processing of these meats. When consumed, the nitrite component breaks down to nitrates in the body, compounds that many like to associate with cancer. While nitrates do not cause cancer, they can form carcinogenic compounds during processing, once in the body, or when cooked at high temperatures. However, meats contribute only 5% of our nitrate intake. In fact, most nitrates that enter our body are from vegetables, so it’s hard to pull all of the nitrate blame on processed meats.  

Is your turkey sandwich worth worrying about?

Compared to other food-related health risks, those from that turkey or ham sandwich are very small. While I wouldn’t skip lunch just because deli meats are the only option, research suggests that minimizing intake or looking for healthier alternatives when possible is good practice.  Here are some ideas to minimize potential risks.

Keep tabs on intake

Processed meats shouldn’t be daily part of your diet, and when you do consume, research suggests keeping daily intake to 50g (1 ½ to 1 ¾ oz) or less.

Purchase “uncured”

These products use vegetable-based preservatives like celery powder instead of salts like sodium nitrite to cure or preserve the meat, and may be labeled “no added nitrates”, but they’re not free of nitrates since vegetables are a primary source. However, many feel better consuming nitrates from a more natural source.

Watch sodium

Reduced- and lower-sodium lunch meats are readily available and usually aren’t missing much salty flavor. Opt for these when possible, but also remember to watch the sodium in other sandwich components like cheese and mustard.

Consider quick alternatives

Thinly slicing cooked chicken breasts for sandwiches avoids the additives and sodium associated with processed meats. Cook chicken or other protein at the start of the week to grab for sandwiches instead of deli meats.

Consider fish or plant-based alternatives

Tuna and salmon make great salads for a sandwich, and consider skipping the meat all together by opting for a veggie sandwich with hummus or cheese.