Another issue, especially in Japan, is that ingested nitrites may react with secondary amines or N-alkylamides to generate carcinogenic N-nitroso compounds (NOCs) [40] and the prevalence of gastric cancer in the Japanese population is very high. Although shown in animal models [41], the proof in humans has not been substantiated. Furthermore, the nitrites in foods may be “neutralized” if accompanied by vitamin C, an antioxidant that inhibits the nitrosation effect of nitrites on secondary amines [42]. Clearly, more research is needed to address whether nitrate and nitrite intake is associated with increased cancer risk.