Let’s Get Frank: A Nutritionist Takes on the Hot Dog

Christie Davidson, MS, RDN, Arivale Coach
Christie Davidson
MS, RDN, Arivale Coach

So many aspects of the classic summer barbecue can be easily healthified. Replace fruit ambrosia with a fresh fruit salad. Sub sparkling water for lemonade. And, of course, add some colorful veggies. But, what to do about the undisputed star of the grill – the humble hot dog?

In general, hot dogs are a food best not overthought. But, there are some things to keep in mind when it comes to buying and cooking frankfurters.

Nitrates and Nitrites

Nitrates and nitrites are chemical compounds added to processed meat as a preservative and are – frankly – quite effective at the job. But, while the research isn’t clear, nitrate and nitrite-containing foods – such as processed meats – have been linked to cancer and other negative outcomes1. And while human studies are lacking, one study did find consuming a large amount of processed meat, as well as red meat, was associated with an increase in overall mortality, cancer mortality, and cardiovascular mortality – though this wasn’t necessarily due to nitrates and nitrites2,3.

Uncured Sausages

Nitrate and nitrite-free hot dogs, sometimes called uncured hotdogs, actually still contain nitrates and nitrites, though they come from more natural sources, such as celery. But, that doesn’t mean you’re in the clear.

Whether cured or not, hot dogs are a processed meat, and the World Health Organization has classified processed meat as a carcinogen – something that probably causes cancer.


Grilling meats at high temperatures can form chemicals that may also increase cancer risk4. Grilling at a lower temperature may help, and, believe it or not, those Wisconsinites who boil their brats in beer may be onto something. Boiling can reduce the formation of potentially cancer-causing compounds in meat. (Although the beer probably isn’t necessary; water does just fine for boiling).

So, what’s to be done about hot dogs?


Consider how you can balance a not-so-healthy food with the rest of your meal, day, or week. For example, have fresh watermelon and a big salad at your barbecue, pack in the kale and cauliflower all week, and make sure you’re keeping active. Why? Fruits and vegetables – particularly the cruciferous family (kale, broccoli, Brussels sprouts, etc.) – and regular activity seem to decrease the risk of cancer5.

Finding the right balance can help you enjoy the occasional hot dog and still be supportive of your long-term health.


There’s a lot to be said about traditions – after all, what’s a baseball game without a hot dog in hand? – and we don’t want to completely deny you the occasional frank. But in the amazing world of free internet recipes, there are so many great options for the grill that aren’t processed, don’t contain nitrates or nitrites, and may even be combined with the occasional vegetable. Branch out and expand your repertoire.

The Other Nitrates and Nitrites

Surprisingly, nitrates and nitrites are also commonly found in fruits and vegetables. Perhaps even more surprisingly, nitrates and nitrites – when found in fruits and veggies – seem to have a number of health benefits, including possibly improving the health of blood vessels and lowering blood pressure6,7,8. You can find nitrates and nitrites in rhubarb, basil, greens, and broccoli.

In the end, the occasional hot dog can likely remain a part of your summer as long as other healthy measures – such as those mentioned above – are in place.

(Or, just go all in and make carrot hot dogs.)


  1. “Cancer Trends Progress Report.” National Cancer Institute. February 2018. https://progressreport.cancer.gov/prevention/red_meat
  2. Sinha, R., Cross, A. J., Graubard, B. I., Leitzmann, M. F., & Schatzkin, A. (2009). “Meat intake and mortality: a prospective study of over half a million people.” Archives of Internal Medicine, 169(6), 562–571. http://doi.org/10.1001/archinternmed.2009.6
  3. Wang X, Lin X, Ouyang YY, Liu J, Zhao G, Pan A, Hu FB. (2016). “Red and processed meat consumption and mortality: dose-response meta-analysis of prospective cohort studies.” Public Health Nutrition, 2016 Apr;19(5):893-905. doi: 10.1017/S1368980015002062
  4. “Chemicals in Meat Cooked at High Temperatures and Cancer Risk.” National Cancer Institute. July 2017. https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/cooked-meats-fact-sheet
  5. “Diet and activity factors that affect risks for certain cancers.” American Cancer Society. February 2016. https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention/diet-and-activity.html
  6. Lara J, Ashor AW, Oggioni C, Ahluwalia A, Mathers JC, Siervo M. (2016). “Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis.” European Journal of Nutrition, 2016 Mar;55(2):451-459. doi: 10.1007/s00394-015-0872-7
  7. Kapil V, Khambata RS, Robertson A, Caulfield MJ, Ahluwalia A. (2015). “Dietary nitrate provides sustained blood pressure lowering in hypertensive patients: a randomized, phase 2, double-blind, placebo-controlled study.” Hypertension, 2015 Feb;65(2):320-7. doi: 10.1161/HYPERTENSIONAHA
  8. Jonvik KL, Nyakayiru J, Pinckaers PJ, Senden JM, van Loon LJ, Verdijk LB. (2016). “Nitrate-Rich Vegetables Increase Plasma Nitrate and Nitrite Concentrations and Lower Blood Pressure in Healthy Adults.” The Journal of Nutrition, 2016 May;146(5):986-93. doi: 10.3945/jn.116.229807