Haem, not protein or inorganic iron, is responsible for endogenous intestinal N-nitrosation arising from red meat.

Many N-nitroso compounds (NOC) are carcinogens. In this controlled study of 21 healthy male volunteers, levels of NOC on a high (420 grams) red meat diet were significantly greater (P = 0.001) than on a low (60 grams) meat diet but not significantly greater when an equivalent amount of vegetable protein was fed. An 8-mg supplement of haem iron also increased fecal NOC (P = 0.006) compared with the low meat diet, but 35-mg ferrous iron had no effect. Endogenous N-nitrosation, arising from ingestion of haem but not inorganic iron or protein, may account for the increased risk associated with red meat consumption in colorectal cancer.